Outcomes of diabetes care: a population-based study.
OBJECTIVE
To describe prevalence, metabolic control, and complications of diabetes mellitus in a county in Northern Sweden, in order to improve diabetes care and guide decision makers.


METHODS
A population-based, cross-sectional, retrospective study of medical records of all registered persons with diabetes mellitus (n = 5251) in the area. Assessments and examinations concerning metabolic control and complications were studied over a period of 15 months.


RESULTS
Of the 5143 patients included, 13% had Type 1, 86% Type 2, and 1% other types of diabetes. An annual check-up was performed in 84% of patients. Glycosylated haemoglobin (HbA1c) was assessed in 88%, and had a mean value of 7.3% (sd 1.3%). Metabolic control was good in 33% and acceptable in another 26%. Risk factors for complications were found in 64%; in 35% body mass index was > 30; 50% had hypertension; 22% were smokers; 51% had macro- and/or microvascular complications; ischaemic heart disease 26%; a cerebrovascular lesion 13%; amputation 1.8%; proteinuria 7.9%; microalbuminuria 2.6%; peripheral neuropathy 30%; impaired peripheral circulation 29%; and retinopathy 37%.


CONCLUSIONS
The majority of patients with diabetes in the study area attended an annual check-up, had acceptable metabolic control and severe complications were uncommon. Nevertheless, the number of undocumented examinations was high, 40% of the patients had unacceptable metabolic control and more than 50% had macrovascular risk factors. These findings emphasize the importance in diabetes care of smoking cessation and intensive treatment of high blood pressure.
Färnkvist
Lisbeth M
LM
Research and Development Unit, Primary Health Care, Sundsvall, Umeå University, Umeå, Sweden.
Lundman
Berit M
BM
D001786:Blood Glucose; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000378:metabolism / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D008297:Male; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D013548:Sweden / Q000453:epidemiology
D001786:Blood Glucose; D006442:Glycated Hemoglobin