title: Glycemic control in patients with diabetes in Finland.
abstract: OBJECTIVE
  To evaluate the quality of diabetes care at a national level in Finland, using level of glycemia as a determinant of success in treatment.
  
  
  METHODS
  Physicians and diabetes nurses in 76 randomly selected clinics (59 primary care units and 17 hospitals) evenly covering the whole of Finland were asked to fill in a questionnaire asking for data based on the 1993 medical records of a random sample of 50 diabetic patients from each center (total n = 3,800). HbAlc was used as an index of glycemic control.
  
  
  RESULTS
  Information on 3,195 (84%) diabetic patients was received. HbAlc was measured in 67% of the patients in 1993. The mean HbAlc in the whole population was 8.6 +/- 1.9% (normal range 4-6%). Some 25% of patients had HbAlc < or = 7.3%, while 25% had HbAlc > or = 9.7%. The mean HbAlc was 8.8 +/- 1.9% in type 1 and 8.5 +/- 1.9% in type 2 diabetic patients. There was no sex difference in the HbAlc level in type 1 diabetic patients. However, male type 2 diabetic patients had better glycemic control than female patients (8.3 +/- 1.9 vs. 8.8 +/- 1.9%, P < 0.0001). The sex difference was independent of the type of therapy. The mean level of glycemic control was lowest among individuals with the shortest duration of diabetes. After 7-9 years after the diagnosis, there was no change in the mean level of glycemia.
  
  
  CONCLUSIONS
  Average glycemic control is poor in a majority of the diabetic patients in Finland. Better treatment strategies and methods should be used to improve glycemic control and to reduce long-term complications.
authors: Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland. timo.valle@ktl.fi
authors: T
authors: T
authors: Valle
authors: V A
authors: VA
authors: Koivisto
authors: A
authors: A
authors: Reunanen
authors: T
authors: T
authors: Kangas
authors: A
authors: A
authors: Rissanen
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003695:Delivery of Health Care; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D019468:Disease Management; D005260:Female; D005387:Finland; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D008297:Male; D011786:Quality Control
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin