Endocrine Abstracts (2013) 32 P396 | DOI: 10.1530/endoabs.32.P396

Quality of care in diabetic patients

Mafalda Marcelino, Andreia Domingues, Armando Pereira, Dolores Passos, Joaquim Raimundo, João Silva, Luis Lopes, Maria Lopes, Paula Chambel, Valentim Santos & João Jácome de Castro

Armed Forces University Hospital, Lisbon, Portugal.

Introduction: Type 2 diabetes mellitus (T2DM) is a chronic disease, with prevalence increasing worldwide and its complications are major causes of early morbidity and mortality. Recent guidelines suggest the individualisation of glycaemic targets and glucose-lowering therapies.

The aim of this study was to determine the quality of care provided to type 2 diabetic patients in our institution, analysing metabolic control, cardiovascular risk factors and prevalence of diabetic complications.

Methods: Transversal study with 423 type 2 diabetic patients, followed at our diabetes clinic.

Results: A total of 423 patients were included in the study, with a mean age of 67±9.4 years. 61.7% were men. Approximately 90% of patients were overweight (41.9% obese). 65.3% had familiar history of T2DM. Mean duration of diabetes was 15±10.5 years and HbA1c levels averaged 7.0±1.2%. 60% had HbA1c ≤7% (40% HbA1c ≤6.5%). Concerning therapeutic regimens: 75% used oral hypoglycaemic agents (OAD) alone (73.4% of these were using two or more agents); 25% were treated with insulin (16% in combination with OAD). 82.3% of the patients had hypertension and 31.2% met the target blood pressure (BP) of 130/80 mmHg. 82.9% had dyslipidaemia and 62.6% met the goal LDL cholesterol level <100 mg/dl. 12% of patients met the combined ADA goal for BP, LDL, and HbA1c. 61.3% of the patients was anti-aggregated.Regarding diabetic complications: 16.7% had retinopathy, 26.4% nephropathy, 23% cardiovascular, and 8.7% cerebrovascular disease.

Conclusions: Metabolic control (HbA1c), BP, and LDL values were favourable in our patients, comparing to other studies. Although, it’s challenging to achieve all the goals proposed by international guidelines.