Journal List > Korean Diabetes J > v.33(3) > 1002296

Lee: The Current Status of Type 2 Diabetes Management at a University Hospital

Abstract

Background

The prevalence of type 2 diabetes has increased worldwide, as have the incidence and mortality of associated cardiovascular complication. However current status of diabetes management is poor. This study was performed to evaluate the management of care for type 2 diabetes patients at a university hospital.

Methods

This study comprised 926 type 2 diabetes patients, over the age of 30, who were treated at the Dongguk University Gyeongju Hospital between January and December 2008. Medical records were reviewed to collect demographic information, biochemical test results and the pharmacologic agents prescribed.

Results

The mean age, duration of diabetes and body mass index were 62.5 ± 11.8 years, 9.1 ± 7.2 year and 24.7 ± 6.3 kg/m2, respectively. There were 251/926 (27.1%) patients with cardiovascular disease. In addition, 49.2% and 27.5% of patients had HbA1c levels < 7% and < 6.5%, respectively. There were 66.3% of the patients with blood pressure < 130/80 mm Hg. Fifty one percent and 47.4% of the patients had an LDL-C < 100 mg/dL and a non-HDL-C < 130 mg/dL, respectively. In addition, 19.7% of the patients with cardiovascular disease had an LDL-C < 70 mg/dL. Antiplatelet agents were used in 81.2% of the patients. The mean number of HbA1c measurements was 1.07 ± 0.7 /year. HbA1c and lipid profiles were not checked in 21.4% and 23.1% of the patients, respectively. Over the previous six months, 6.9% of the patients had not had their blood pressure monitored.

Conclusion

Among the patients with type 2 diabetes evaluated, 30~70% received in inadequate level of care. These findings point to the need for more aggressive efforts for optimal metabolic control.

Figures and Tables

Fig. 1
Proportions of antiplatelet, antihypertensive and lipid lowering medications in study subjects with associated cardiovascular disease. *P < 0.01 by Chi-square test. CVD, cardiovascular disease; OHA, oral hypoglycemic agents.
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Fig. 2
Proportion of study subjects who achieved the therapeutic goals.
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Table 1
Baseline characteristics of study subjects
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HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein-cholesterol.

Table 2
Status of associated diabetic complications in type 2 diabetic patients
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CVA, cereborvascular accidents; IHD, ischemic heart disease; NPDR, nonproliferative diabetic retinopathy; PDR, proliferative diabetic retinopathy.

Table 3
Diabetes management of study subjects
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OHA, oral hypoglycemic agent.

Table 4
Metabolic characteristics according to the status of achieved therapeutic goals
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Data are expressed as mean ± SE. *P < 0.01 by student t-test, P < 0.05 by student t-test. dBP, diastolic blood pressure; HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein-cholesterol; No, number; sBP, systolic blood pressure; Tchol, total cholesterol; TG, triglycerides.

Table 5
Clinical characteristics of the patients who achieved the therapeutic goals
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*P < 0.01 by Chi-square test. P < 0.01 by Chi-square for trend. P < 0.05 by Chi-square for trend. §anti-hypertensive drug. oral hypoglycemic agents. insulin (± oral hypoglycemic agent). **lipid lowering agents. BMI, body mass index; CVD, cardiovascular disease; LDL-C, low density lipoprotein-cholesterol; No, number.

Table 6
Logistic regression analysis of the relationship between proportion of the patients who achieved therapeutic goal and associated variables
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BMI, body mass index; CI, confidence interval; LDL-C, low density lipoprotein-cholesterol.

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