title: Prevalence of complications among Chinese diabetic patients in urban primary care clinics: a cross-sectional study.
abstract: BACKGROUND
  A territory-wide diabetes management program (Risk Assessment Management Program - RAMP) was recently established, providing comprehensive management for all diabetics, helping to delineate current level of control and complications prevalence among primary care diabetic patients in Hong Kong.
  
  
  METHODS
  This cross-sectional study captured anonymous clinical data from RAMP patients. Data obtained include sociodemographic details, type of diabetes, illness duration, family history, drug usage, coexisting illnesses, diabetic complications and other clinical parameters.
  
  
  RESULTS
  Data from 15,856 type 2 diabetic patients were analyzed. 57.1% were above 60 years old, with mean disease duration of 7.3 years. Hypertension was the commonest coexisting chronic illness (57.6%). 30.2% and 61.8% have their systolic and diastolic pressure controlled to below 130 mmHg and 80 mmHg respectively. Over half (51.5%) had an HbA1c level of less than 7.0%. 88.4% did not achieve target lipid level. 15% were on diet control alone. Only 22.2% were on statins. In patients with microalbuminuria and macroalbuminuria, 40.7% and 54.5% were on angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) respectively. 12.9%, 38.8% and 2.4% had diabetic retinopathy, nephropathy and neuropathy respectively. Overall, 37.9%, 7.3% and 0.4% had single, two and three concurrent microvascular complications respectively.
  
  
  CONCLUSIONS
  The level of diabetic control is comparable with other developed countries. We demonstrated a high prevalence of microvascular complications among Chinese primary care patients despite achieving adequate HbA1c levels, highlighting the importance of managing all aspects of diabetes including weight, lipid and blood pressure. Efforts to improve holistic management must be tailored according to the needs of our population, with the challenges that the majority have low educational background and in the older age group.
authors.forename: Kenny
authors.initials: K
authors.lastname: Kung
authors.forename: Kai Ming
authors.initials: KM
authors.lastname: Chow
authors.forename: Eric Ming-Tung
authors.initials: EM
authors.lastname: Hui
authors.forename: Maria
authors.initials: M
authors.lastname: Leung
authors.forename: Shuk Yun
authors.initials: SY
authors.lastname: Leung
authors.forename: Cheuk Chun
authors.initials: CC
authors.lastname: Szeto
authors.forename: Augustine
authors.initials: A
authors.lastname: Lam
authors.affiliation: Department of Family Medicine, New Territories East Cluster, Hospital Authority, Shatin, Hong Kong. philipli@cuhk.edu.hk.
authors.forename: Philip Kam-Tao
authors.initials: PK
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D018570:Risk Assessment; D014504:Urban Health; D055815:Young Adult