Metabolic control of diabetes in a diabetes centre.
OBJECTIVE
To examine the effectiveness of a diabetes centre in restoring metabolic control in patients with poorly controlled diabetes.


METHODS
Retrospective review of medical records.


METHODS
Diabetes centre of a district hospital, Hong Kong.


METHODS
Patients with poorly controlled diabetes referred to a diabetes centre.


METHODS
Primary endpoints were mean change in glycated haemoglobin levels and the number of patients who achieved glycated haemoglobin levels of 7.0% or lower, 7.5% or lower, and 8.0% or lower, respectively. Complementary endpoints were serial changes in body weight, blood pressure, and lipids.


RESULTS
One hundred and eighty-five patients, predominantly with type 2 diabetes (94.6%), were reviewed. Median duration since diagnosis of diabetes was 8 years (interquartile range, 4.3-11.8 years). Seventy-three patients had a body mass index of 25 kg/m(2) or higher. The baseline and latest glycated haemoglobin levels were 10.4% (standard deviation, 2%) and 8.2% (1.4%), respectively; mean reduction was 2.2% (95% confidence interval, 1.9-2.5; P<0.0005). Eighty-one patients were discharged after a median 32 weeks of follow-up. Their mean glycated haemoglobin level on discharge was 7.5% (0.8%), and the mean reduction was 2.8% (95% confidence interval, 2.4-3.3; P<0.0005). The cumulative percentages of discharged patients who achieved glycated haemoglobin levels of less than 7.0%, 7.5%, and 8.0% were 30.9%, 53.1%, and 77.8%, respectively. Newly diagnosed diabetes (P=0.006) was the only factor which predicted a favourable glycaemic response. CONCLUSION. The Diabetes Centre provided effective management for a heterogeneous group of patients referred with poorly controlled diabetes.
Lam
W M S
WM
Department of Medicine and Geriatrics, Yan Chai Hospital, 7-11 Yan Chai Street, Tsuen Wan, Hong Kong.
Li
J K Y
JK
Leung
A Y S
AY
Kwan
W K
WK
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000378:metabolism* / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008055:Lipids / Q000032:analysis; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D009765:Obesity; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008055:Lipids