title: Patient outcomes from 10 years of annual diabetes reviews in New Zealand.
abstract: OBJECTIVE
  To examine trends in patient health outcomes 2001-2010 for patients receiving free annual diabetes reviews in New Zealand.
  
  
  METHODS
  Clinical, demographic and hospital admissions data were analysed for 2175 Type 1 and 25,436 Type 2 diabetes mellitus patients presenting at 170 general practices. Changes in clinical measures and proportions of patients achieving guideline targets and receiving recommended processes of care were assessed by calendar year and for patients returning for successive annual diabetes reviews. We also examined trends in hospital admission rates for diabetes complications over the ten years.
  
  
  RESULTS
  The proportion of patients achieving guideline levels for blood pressure and cholesterol increased significantly and there were decreases in smoking rates and mean BMI for patients reviewed five times. The proportion of patients meeting guideline levels for HbA1c increased by year but decreased in patients returning for five reviews. There was also a reduction in the proportion of patients with poor glycaemic control (HbA1c>9.0% (75 mmol/mol)). The proportion of Type 2 patients using oral hypoglycaemic agents or insulin and receiving a retinal exam in the last two years increased significantly, and over 90% of patients received foot checks. Hospital admission rates for ischaemic heart disease, peripheral circulatory disorders, and ketoacidosis all decreased over the period 2001-2010 but inpatient admissions for eye, neurological and renal problems specific to diabetes increased.
  
  
  CONCLUSIONS
  There have been many improvements in health outcomes for these diabetes patients participating in the New Zealand government's programme to provide free annual health checks, despite the increasing age and diabetes duration of the patient cohorts.
authors.affiliation: Best Practice Advocacy Centre, Dunedin, New Zealand.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Tomlin
authors.forename: Susan M
authors.initials: SM
authors.lastname: Dovey
authors.forename: Murray W
authors.initials: MW
authors.lastname: Tilyard
mesh_terms: D000368:Aged; D048909:Diabetes Complications / Q000188:drug therapy; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Diabetes complications; Diabetes mellitus; General practice; Hospitalisation