A multinational, multi-centre, observational, cross-sectional survey assessing diabetes secondary care in Central and Eastern Europe (DEPAC Survey).
OBJECTIVE
The objective of this study was to assess diabetes care in outpatient diabetes clinics in the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia and Slovenia.


METHODS
Questionnaires for each randomly enrolled patient were completed by an endocrinologist or diabetologist. Data concerning age, sex, diabetes duration, diabetes type, treatment type, glycated haemoglobin (HbA(1c)), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C), blood pressure (BP) and short- and long-term diabetes complications were recorded. Questionnaires were analysed centrally for each country and stratified for Type 1 diabetes (T1D), Type 2 diabetes (T2D) and other types of diabetes.


RESULTS
Data on 10 950 individuals were analysed (mean population age 56.2 years; females 52%; T1D 22.9%; T2D 75.3%; mean time from diagnosis 11 years). Patients with HbA(1c) within target (< 6.5%): T1D 13.1%, T2D 21.4%; for TC levels (< 4.5 mmol/l): T1D 37%, T2D 20%; for TG levels (< 1.7 mmol/l): T1D 78%, T2D 44%; for HDL-C (> 1.1 mmol/l): T1D 81%, T2D 60%; for LDL-C (< 2.5 mmol/l): T1D 36%, T2D 23%; for BP (< 130/80 mm Hg): T1D 42%, T2D 9%. The prevalence of severe hypoglycaemia (within the last 6 months) was 12% in T1D and 2% in T2D. Prevalence of diabetic ketoacidosis was 0.3-6.6%, blindness 0.15-1.3% and diabetic nephropathy 19-42%.


CONCLUSIONS
The data show the current quality of care and potential areas for improvement. The quality of care is generally comparable with that in Western Europe.
Andel
M
M
Center for Research of Diabetes, Metabolism and Nutrition and 2nd Department of Internal Medicine, Third Faculty of Medicine, Charles University Prague, Czech Republic. michal.andel@lf3.cuni.cz
Grzeszczak
W
W
Michalek
J
J
Medvescek
M
M
Norkus
A
A
Rasa
I
I
Niewada
M
M
Kamiński
B
B
Kraml
P
P
Madacsy
L
L
D000328:Adult; D000553:Ambulatory Care / Q000592:standards*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy; D003928:Diabetic Nephropathies / Q000628:therapy; D003930:Diabetic Retinopathy / Q000628:therapy; D005061:Europe, Eastern; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged
D015415:Biomarkers; D006442:Glycated Hemoglobin