Maintenance of good glycaemic control is challenging - A cohort study of type 2 diabetes patient in North Karelia, Finland

Int J Clin Pract. 2019 Apr;73(4):e13313. doi: 10.1111/ijcp.13313. Epub 2019 Feb 8.

Abstract

Aims: This study assessed type 2 diabetes treatment outcomes and process indicators using a comprehensive type 2 diabetes patient cohort in North Karelia, Finland, from 2011 to 2016.

Methods: Data from all diagnosed type 2 diabetes patients (n = 8429) living in North Karelia were collated retrospectively from regional electronic patient records. We assessed whether HbA1c and low-density lipoprotein (LDL) were measured and managed as recommended.

Results: The HbA1c measurement rate improved (78% vs 89%) during 2011-2012 and 2015-2016, but a gradual deterioration in glycaemic control (HbA1c < 7.0% or 53 mmol/mol) was observed among both females (75% vs 67%) and males (72% vs 64%). The LDL measurement rate initially improved from the baseline. LDL control (<2.5 mmol/L) improved among both females (52% vs 59%) and males (58% vs 66%). A gender difference was observed in the achievement of the treatment target for LDL, with females showing worse control.

Conclusions: Low-density lipoprotein (LDL) control in type 2 diabetes patients has improved, but the existence of gender disparities needs further attention. Maintaining appropriate HbA1c control among type 2 diabetes patients over time appears to be difficult. Active follow-up and tailored treatment have the potential to improve the quality of care. Electronic patient records could be more efficiently used to improve the quality of care and to support decision-making.

MeSH terms

  • Blood Glucose / analysis
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / therapy*
  • Disease Management
  • Electronic Health Records
  • Female
  • Finland
  • Glycated Hemoglobin A / metabolism*
  • Humans
  • Male
  • Outcome Assessment, Health Care
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome

Substances

  • Blood Glucose
  • Glycated Hemoglobin A