The association between glycemic, lipids and blood pressure control among Israeli diabetic patients.
BACKGROUND
It is recommended that in diabetes mellitus patients all risk factors for cardiovascular disease should be controlled.


OBJECTIVE
To evaluate the rate of reaching all glycemic, lipids and blood pressure target levels among diabetic patients in Israel and to analyze demographic and clinical parameters associated with it.


METHODS
A cross-sectional study.


METHODS
The study was conducted in Maccabi Healthcare Services, Israel's second largest health maintenance organization. All patients (n = 41 936), older than 20 years, who were listed on Maccabi Healthcare Service's diabetes mellitus computerized database and had all three study parameters (HbA1c, LDL-C and blood pressure levels during 2005) were eligible for the study. The rate of reaching HbA1c <7.0%, LDL-C <100 mg/dl and blood pressure <130/85 mmHg, as well as its association with various demographic and clinical parameters were analyzed.


RESULTS
Only 13% of all study patients achieved all three target levels. The parameters which were significantly associated with goal achievement were compliance to medical treatment for all three parameters (OR 1.56, 95% CI 1.44-1.69, P = 0.0001), male gender (OR 1.42, 95% CI 1.31-1.54, P = 0.0001), comorbidity with ischemic heart disease (OR 1.23, 95% CI 1.13-1.34, P = 0.0001), and >12 visits per year to family physician (OR 1.10, 95% CI 1.02-1.19, P = 0.012).


CONCLUSIONS
Non-compliance with treatment and sub-optimal follow-up by family physicians are associated with increased risk of failure to control major risk factor among diabetic patients.
Elis
A
A
Department of Medicine A, Meir Medical Center, Kfar Saba, Israel. avishayel@clalit.org.il
Rosenmann
L
L
Chodick
G
G
Heymann
A D
AD
Kokia
E
E
Shalev
V
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000517:prevention & control*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000517:prevention & control*; D007557:Israel / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D016312:Treatment Refusal
D001786:Blood Glucose; D008055:Lipids