Abstract
BackgroundDiabetes and its complications are substantial causes of morbidity and mortality, and caused approximately 5.1 million deaths worldwide in 2013. Early detection and treatment of diabetes complications can prevent their progression.ObjectThis study compared the proportions of patients with type 1 and 2 diabetes mellitus (T1DM and T2DM, respectively) who achieved the goals of good clinical control.MethodsAdults and elderly patients with T1DM and T2DM at a public outpatient endocrinology service in Brazil were retrospectively evaluated between 2012 and 2013. Clinical and socio demographic data were obtained from medical records and evaluated in accordance with the Brazilian Diabetes Society Guidelines. Care process measures, outcomes indicators, and supporting process measures were evaluated.ResultsA total of 1031 records were analyzed: 29 and 71 % of patients had T1DM and T2DM, respectively. T2DM patients had significantly higher BMI than T1DM patients (overweight and obesity in 85.1 vs. 47.5 %, p < 0.01). The follow-up periods for diabetes and number of clinical visits to the endocrinology service were significantly greater among T1DM patients than T2DM patients (p < 0.01). However, T2DM patients required significantly more other (i.e., non-endocrinological) healthcare services (p < 0.01). HbA1c was significantly lower in T2DM patients (p < 0.01). Moreover, blood pressure and triglycerides were significantly higher in T2DM patients (p < 0.01), whereas total cholesterol and low-density lipoprotein were significantly lower in T2DM patients (p < 0.01). Only 0.5 % of the patients achieved all targets, and 1.1 % did not achieve any.ConclusionsThe achievement of goals of good clinical practice varies among the parameters evaluated. Almost no patients achieved all targets. Many patients are overweight and do not achieve targets for HbA1c, lipid profile, or blood pressure control.
Highlights
Diabetes and its complications are substantial causes of morbidity and mortality, and caused approximately 5.1 million deaths worldwide in 2013
The achievement of goals of good clinical practice varies among the parameters evaluated
Data were collected on the basis of the goals for adequate metabolic control and management of diabetes recommended by the Brazilian Diabetes Society (BDS) Guidelines [16]
Summary
In 2013, an estimated 382 million people had diabetes, The disease is classified as type 1 diabetes mellitus (T1DM), accounting for 5–10 % of cases, and type 2. Baptista et al Diabetol Metab Syndr (2015) 7:113 diabetes mellitus (T2DM), accounting for 90–95 % of cases. Defective insulin secretion and/or action results in hyperglycemia, which is associated with long-term complications, dysfunction, and failure including retinopathy, nephropathy, peripheral neuropathy with a risk of foot ulcers, lower-limb amputations, Charcot joints, autonomic neuropathy, sexual dysfunction, cardiovascular disease, hypertension, and lipoprotein abnormalities [9]. Diabetes and its complications are substantial causes of morbidity and mortality, and caused approximately 5.1 million deaths worldwide in 2013 [1, 8]
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