Abstract
BackgroundA territory-wide diabetes management program (Risk Assessment Management Program – RAMP) was recently established, providing comprehensive management for all diabetics, helping to delineate current level of control and complications prevalence among primary care diabetic patients in Hong Kong.MethodThis cross-sectional study captured anonymous clinical data from RAMP patients. Data obtained include sociodemographic details, type of diabetes, illness duration, family history, drug usage, coexisting illnesses, diabetic complications and other clinical parameters.ResultsData from 15,856 type 2 diabetic patients were analyzed. 57.1% were above 60 years old, with mean disease duration of 7.3 years. Hypertension was the commonest coexisting chronic illness (57.6%). 30.2% and 61.8% have their systolic and diastolic pressure controlled to below 130 mmHg and 80 mmHg respectively. Over half (51.5%) had an HbA1c level of less than 7.0%. 88.4% did not achieve target lipid level. 15% were on diet control alone. Only 22.2% were on statins. In patients with microalbuminuria and macroalbuminuria, 40.7% and 54.5% were on angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) respectively. 12.9%, 38.8% and 2.4% had diabetic retinopathy, nephropathy and neuropathy respectively. Overall, 37.9%, 7.3% and 0.4% had single, two and three concurrent microvascular complications respectively.ConclusionThe level of diabetic control is comparable with other developed countries. We demonstrated a high prevalence of microvascular complications among Chinese primary care patients despite achieving adequate HbA1c levels, highlighting the importance of managing all aspects of diabetes including weight, lipid and blood pressure. Efforts to improve holistic management must be tailored according to the needs of our population, with the challenges that the majority have low educational background and in the older age group.
Highlights
A territory-wide diabetes management program (Risk Assessment Management Program – RAMP) was recently established, providing comprehensive management for all diabetics, helping to delineate current level of control and complications prevalence among primary care diabetic patients in Hong Kong
Data from RAMP provides an exceptional opportunity to delineate the current level of control and prevalence of complications among primary care diabetic patients in Hong Kong
This study is a cross-sectional study, collecting anonymised computerized clinical data obtained from RAMP in eight public primary care clinics of Hong Kong
Summary
A territory-wide diabetes management program (Risk Assessment Management Program – RAMP) was recently established, providing comprehensive management for all diabetics, helping to delineate current level of control and complications prevalence among primary care diabetic patients in Hong Kong. All information is recorded electronically, allowing healthcare providers to review patients’ conditions in a much more effective and efficient way This has enabled healthcare providers to review the level of control and prevalence of complications among diabetic patients. There is currently limited primary care data on the level of control and the prevalence of complications, which are essential in helping service providers to correctly allocate healthcare resources.
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