Treatment of type 1 diabetes in the specialist health service--data from the Norwegian Diabetes Register for Adults.
BACKGROUND
The Norwegian Diabetes Register for Adults was established in 2005. The aim of the study is to assess the quality of treatment for adult patients with type 1 diabetes in the specialist health service based on register data.


METHODS
We included patients ≥ 18 years with type 1 diabetes in the specialist health service for whom the register has data for the period from 1 July 2010-to 31 December 2011. The patients were asked to consent to the transfer of data to the register when they attended a routine consultation. As of 31 December 2011, 95% of the patients asked gave their consent. It is not known how large a proportion of patients were asked.


RESULTS
We included the last registered data for 3,697 patients (46.8% women) from 24 outpatient clinics and specialist centres. The average age was 41.8 years and the average duration of diabetes was 20.8 years. Median HbA1c, systolic blood pressure and LDL cholesterol were 8.0%, 126 mm Hg and 2.8 mmol/l respectively. 9.8% achieved all treatment targets set out in the national guidelines for diabetes. 18% had HbA1c ≤ 7.0%, while 22% had HbA1c ≥ 9%. 39% of patients on statin therapy achieved the treatment target for LDL cholesterol. 19.6% smoked on a daily basis. 14.9% had received treatment for retinopathy and 5.8% had experienced coronary heart disease. There was no record of foot examination or ophthalmoscopy being performed in 33% and 29% of patients.


CONCLUSIONS
The preliminary register data indicate that diabetes treatment should be improved both with respect to the implementation of recommended procedures and the proportion of patients who achieve the treatment targets.
John G
JG
Cooper
Tor
T
Claudi
Hrafnkell B
HB
Thordarson
Karianne Fjeld
KF
Løvaas
Siri
S
Carlsen
Sverre
S
Sandberg
Geir
G
Thue
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D008078:Cholesterol, LDL / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D010044:Outpatient Clinics, Hospital / Q000592:standards; D010808:Physical Examination / Q000592:standards; D011787:Quality of Health Care; D012042:Registries
D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin