[Management of patients with type 2 diabetes. Results in 12 practices of general practitioners].
OBJECTIVE
The care of patients with type 2 diabetes mellitus (2DM) is of great medical and sociopolitical importance. Many such patients are well provided for exclusively within general practice (general practitioners). But evidence based data of this level of medical care has been scarce. Our study reports the experience of the structure and medical management of a population-representative collective of patient with 2DM under the care of general practitioners.


METHODS
Included were all type 2 diabetics seen by 12 general practitioners (from two regions) during the second quarter of 2000. Standardized questionnaires for both patients and doctors provided the basic data on 2DM, other illnesses, symptoms, relevant items on life style and quality of life related to health. Data on patients living in care homes or visited in their home were handled separately.


RESULTS
The collective consisted of 1065 patients with 2DM, aged over 40 years. Many of them had associated illnesses: hypertension in 71%, hypercholesteremia in 53%, coronary heart disease in 29%. Mean values of relevant metabolic parameters were: HbA1c 7.1%, total cholesterol 221.4 mg/dl. Many patients were clearly overweight and had other risk factors. Patient compliance, as reported by their doctors, were "very good" or "rather good" in 63%, while "very poor" or "rather poor" in 36%.


CONCLUSIONS
Patients with 2DM under the care of general practitioners had a high incidence of associated illnesses. The quality of medical care, as measured by relevant metabolic vales, e.g. HbA1c were apparently good. Lipid-lowering drugs and aspirin should be given more widely to decrease cardiovascular events. Primary prevention (especially more exercise and weight loss) and better compliance should be intensified in future.
Rothenbacher
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Abtlg. für Epidemiologie des Deutschen Zentrums für Alternsforschung (DZFA), an der Universität Heidelberg, Germany. rothenbacher@dzfa.uni-heidelberg.de
Rüter
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Saam
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Brenner
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D003927:Diet, Diabetic; D015444:Exercise; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009765:Obesity; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents