Meeting targets in type 2 diabetes care contributing to good glycaemic control. A cross-sectional study from a primary care setting in Estonia.
OBJECTIVE
To assess glycaemic control among Estonian patients with type 2 diabetes mellitus (DM2) and to find patient and disease related factors associated with adequate glycaemic control.


METHODS
A cross-sectional study of 200 randomly selected DM2 patients from a primary care setting. Data on each patient's glycosylated haemoglobin (HbA1c), body mass index, blood pressure, and medications for treatment of DM2 were provided by family doctors. A structured patient questionnaire was administered as a telephone interview (n = 166). The patients' self-management behaviour, awareness of the HbA1c test and its recent value were inquired.


RESULTS
The mean HbA1c of the DM2 patients was 7.5%. The targets of DM2 treatment were achieved as follows: 39% of the patients had HbA1c below 6.5% and half the patients had HbA1c below 7%. More than third of the patients had systolic blood pressure below 140 mmHg and in 51% of the patients diastolic blood pressure was below 85 mmHg. Six per cent of the patients were in normal weight (<25 kg/m(2)). Fifty-two per cent of the patients were aware of the HbA1c test and 36% of them knew its recent value. In multivariate regression analysis, awareness of the HbA1c test but not the HbA1c value, longer duration of diabetes and not having a self-monitoring device were independently associated with adequate glycaemic control (HbA1c< 6.5%).


CONCLUSIONS
The studied DM2 patients often did not reach the clinical targets suggested in the guidelines. Awareness of the HbA1c test was related to better glycaemic control. However, advanced stage of the disease had a negative effect on HbA1c.
Rätsep
Anneli
A
Department of Family Medicine, University of Tartu, Estonia. anneli.ratsep@ut.ee
Kalda
Ruth
R
Lember
Margus
M
D000368:Aged; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects*; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D001794:Blood Pressure; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004957:Estonia; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011320:Primary Health Care / Q000379:methods; D012044:Regression Analysis; D012307:Risk Factors; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents