Quality of care in a diabetic outpatient clinic
Ema Lacerda Nobre, Paula Chambel, Andreia Domingues, Marlene Paes da Silva, Zulmira Jorge, Valentim Santos, Joaquim Raimundo & João Jácome de Castro
Background and aims: Type 2 Diabetes Mellitus affects a growing number of people allover the world. It is associated with serious complications. Several studies have shown that it is possible to prevent and minimize type 2 diabetes complications if it is treated appropriately over time. In our Hospital there is, since 1998, an outpatient clinics of diabetes. This study aimed to determine the quality of care provided to diabetic patients in our institution.
Subjects and methods: We reviewed the medical records of 776 diabetic patients, receiving care at our outpatient clinics since 1998.
Results: A total of 588 patients were included in the study, 58% were men with a mean age of 66.8±27.2. HbA1c levels averaged 7.2±1.65. 25.3% met the target blood pressure of 130/80 mmHg; 48% met the goal LDL cholesterol level <100 and 80% <130 mg/dl. 6.8% of patients met the combined ADA goal for BP, LDL and HbA1c. Concerning therapeutic regimens: 71.5% used oral hypoglycaemic agents (OAD) alone (52.1% of these were using 2 or more agents); 28.5% were treated with insulin (16.2% in combination with OAD).
Conclusions: HbA1c values reflects a good metabolic control. We emphasise the importance of combined therapy in the achievement of optimal glycaemic levels.The percentage of patients treated to the recommended BP of 130/80 mmHg is consistent with the results of other studies. LDL cholesterol levels compares favourable to the NHANES III study and is comparable with other published data. Despite the proved benefits of CV risk factors control in diabetic patients, international recommendations are difficult to achieve in clinical practice.