Abstract

Objective: To assess the total prevalence of types 1 and 2 diabetes and to describe and compare cardiovascular risk factors, vascular complications and the quality of diabetes care in adults with types 1 and 2 diabetes in Salten, Norway. Research design and methods: Cross-sectional study including all patients with diagnosed diabetes in primary and specialist care in Salten, 2014 (population 80,338). Differences in cardiovascular risk factors, prevalence of vascular complications and attained treatment targets between diabetes types were assessed using regression analyses. Results: We identified 3091 cases of diabetes, giving a total prevalence in all age groups of 3.8%, 3.4% and 0.45% for types 2 and 1 diabetes, respectively. In the age group 30–89 years the prevalence of type 2 diabetes was 5.3%. Among 3027 adults aged 18 years and older with diabetes, 2713 (89.6%) had type 2 and 304 (10.0%) type 1 diabetes. The treatment target for haemoglobin A1c (⩽7.0%/53 mmol/mol) was reached in 61.1% and 22.5% of types 2 and 1 diabetes patients, respectively. After adjusting for age, sex and diabetes duration we found differences between patients with types 2 and 1 diabetes in mean haemoglobin A1c (7.1% vs. 7.5%, P<0.001), blood pressure (136/78 mmHg vs. 131/74 mmHg, P<0.001) and prevalence of coronary heart disease (23.1% vs. 15.8%, P<0.001). Conclusions: The prevalence of diagnosed type 2 diabetes was slightly lower than anticipated. Glycaemic control was not satisfactory in the majority of patients with type 1 diabetes. Coronary heart disease was more prevalent in patients with type 2 diabetes.

Highlights

  • Type 1 and type 2 diabetes are complex metabolic diseases that differ in pathophysiology and treatment

  • We aimed to identify gaps in the quality of care for type 1 and type 2 diabetes patients in this population by comparing cardiovascular risk factors, vascular complications and attained treatment targets according to national guidelines

  • When we extrapolated the proportion of immigrants from Asia and Africa in Norway to diabetes prevalence in Salten, with a prevalence of diabetes in this group set to 15%, the prevalence of diabetes in the 30–89 years age group increased marginally from 5.3% to 5.4% [10]

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Summary

Introduction

Type 1 and type 2 diabetes are complex metabolic diseases that differ in pathophysiology and treatment. The global prevalence of diabetes in adults (age 18– 99 years) in 2017 was estimated to be 8.4% and a worrisome increase is predicted worldwide in the coming years [1]. In Norway the prevalence of type 2 diabetes was reported to be 6.1% (age 30–89 years) in 2014 [3]. Repeated Norwegian cross-sectional surveys have shown improvements in the achievement of diabetes treatment targets over time [7]. The treatment targets are identical in type 1 and type 2 diabetes, identifying subgroups in need of closer follow-up and overcoming the barriers achieving treatment targets will be more important in the coming years

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