title: Process measures and outcome research as tools for future improvement of diabetes treatment quality.
abstract: OBJECTIVE
  Good metabolic control, careful monitoring of late diabetic complications and early intervention against cardiovascular risk factors improve the prognosis in Type 1 and Type 2 diabetic patients. The aim of the present study was to analyse the treatment quality in a routine outpatient clinic.
  
  
  METHODS
  A descriptive survey of unselected outpatient Type 1 diabetic patients followed from 1995 to 1997.
  
  
  METHODS
  The outpatient clinic at Steno Diabetes Center, Denmark.
  
  
  METHODS
  2011 unselected Type 1 diabetic patients, representatives for the County of Copenhagen, Denmark.
  
  
  METHODS
  Levels of metabolic control, screening frequencies for late diabetic complications and cardiovascular risk factors.
  
  
  RESULTS
  The mean age (SD) and diabetes duration of the patients were 49 (16) (SD) and 20 (13) years, respectively, and 54% of the patients were males. Glycosylated haemoglobin A(1c) (HbA(1c)) was measured at least once yearly in >99.5% of the patients, and the annual number of measurements was 3 pt(-1). The mean HbA(1c) (normal 4.1-6.4%) was 8.8, 8.7 and 8.6% in 1995, 1996, 1997, respectively. The frequency of HbA(1c)<140% of the non-diabetic mean (HbA(1c)<7.5%) was 14.6, 15.4 and 17.7% in the 3 years (P<0.05). Urinary albumin excretion was measured in 87.0, 87.1 and 80.5%, and blood pressure in 71.4, 76.7 and 79.8% in the 3 years, respectively. In the 3-year period, foot examination and fundus photography were performed at least once in 84.7 and 88.6%, respectively.
  
  
  CONCLUSIONS
  in unselected Type 1 diabetic patients followed at the outpatient clinic at Steno Diabetes Center, only some, but not all, important clinical variables are measured at high frequency despite standard operation procedures. Continuous collection of data may help to explain why there is such a difference.
authors.affiliation: The Steno Diabetes Center, Gentofte, Denmark. tonny.jensen.tj@hh.hosp.dk
authors.forename: Tonny
authors.initials: T
authors.lastname: Jensen
authors.forename: Lise
authors.initials: L
authors.lastname: Musaeus
authors.forename: Brian
authors.initials: B
authors.lastname: Molsing
authors.forename: Benny
authors.initials: B
authors.lastname: Lyholm
authors.forename: Thomas
authors.initials: T
authors.lastname: Mandrup-Poulsen
mesh_terms: D000419:Albuminuria; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003695:Delivery of Health Care / Q000379:methods* / Q000592:standards; D003718:Denmark; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D017719:Diabetic Foot / Q000517:prevention & control; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008991:Monitoring, Physiologic / Q000592:standards; D017063:Outcome Assessment, Health Care / Q000379:methods; D010044:Outpatient Clinics, Hospital; D011785:Quality Assurance, Health Care
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin