title: Proportion of Brazilian diabetes patients that achieve treatment goals: implications for better quality of care.
abstract: BACKGROUND
  Diabetes and its complications are substantial causes of morbidity and mortality, and caused approximately 5.1 million deaths worldwide in 2013. Early detection and treatment of diabetes complications can prevent their progression.
  
  
  OBJECTIVE
  This study compared the proportions of patients with type 1 and 2 diabetes mellitus (T1DM and T2DM, respectively) who achieved the goals of good clinical control.
  
  
  METHODS
  Adults and elderly patients with T1DM and T2DM at a public outpatient endocrinology service in Brazil were retrospectively evaluated between 2012 and 2013. Clinical and socio demographic data were obtained from medical records and evaluated in accordance with the Brazilian Diabetes Society Guidelines. Care process measures, outcomes indicators, and supporting process measures were evaluated.
  
  
  RESULTS
  A total of 1031 records were analyzed: 29 and 71 % of patients had T1DM and T2DM, respectively. T2DM patients had significantly higher BMI than T1DM patients (overweight and obesity in 85.1 vs. 47.5 %, p < 0.01). The follow-up periods for diabetes and number of clinical visits to the endocrinology service were significantly greater among T1DM patients than T2DM patients (p < 0.01). However, T2DM patients required significantly more other (i.e., non-endocrinological) healthcare services (p < 0.01). HbA1c was significantly lower in T2DM patients (p < 0.01). Moreover, blood pressure and triglycerides were significantly higher in T2DM patients (p < 0.01), whereas total cholesterol and low-density lipoprotein were significantly lower in T2DM patients (p < 0.01). Only 0.5 % of the patients achieved all targets, and 1.1 % did not achieve any.
  
  
  CONCLUSIONS
  The achievement of goals of good clinical practice varies among the parameters evaluated. Almost no patients achieved all targets. Many patients are overweight and do not achieve targets for HbA1c, lipid profile, or blood pressure control.
authors.affiliation: Post Graduate Program in Pharmaceutical Sciences, Federal University of Parana, Av. Pref. Lothario Meissner, 632, Jardim Botânico, Curitiba, PR Brazil.
authors.forename: Deise Regina
authors.initials: DR
authors.lastname: Baptista
authors.affiliation: CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico), Brasilia, Brazil.
authors.forename: Rubia Daniela
authors.initials: RD
authors.lastname: Thieme
authors.affiliation: Program of Pharmaceutical Sciences, Federal University of Parana, Curitiba, Brazil.
authors.forename: Walleri Christini Torelli
authors.initials: WC
authors.lastname: Reis
authors.affiliation: Program of Pharmaceutical Sciences, Federal University of Parana, Curitiba, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pontarolo
authors.affiliation: Program of Pharmaceutical Sciences, Federal University of Parana, Curitiba, Brazil.
authors.forename: Cassyano Januário
authors.initials: CJ
authors.lastname: Correr
keywords: Diabetes care; Goals of good clinical practice; Support network