title: Quality of diabetes care at the largest outpatient clinics in Vilnius.
abstract: BACKGROUND
  Essential data on the quality of diabetes care needed for the development of National Diabetes Programme in Lithuania are lacking. The aim of the study was to assess the quality of diabetes care compared to the local guidelines in Vilnius, Lithuania.
  
  
  METHODS
  Retrospective data collection covering the period from 2012 to 2013 was performed in 5 Vilnius outpatient clinics assessing process and outcome indicators in type 1 (T1DM) and type 2 diabetes mellitus (T2DM) subjects.
  
  
  RESULTS
  In a sample of 1,719 patients (58.9% women, 92.6% T2DM) the annual HbA1c assessment rate was 88.6%. Glycaemic control was significantly better in T2DM compared to T1DM patients: average HbA1c was 7.0 ± 1.4% vs 9.1 ± 1.8% and HbA1c ≤ 7% in 59 vs 9.4%, respectively (p< 0.001); referrals to an endocrinologist were recommended in 56.3% of cases. Annual screening for diabetic foot, retinopathy, nephropathy, renal function and lipids was performed in 4.6, 24.4, 2.3, 29.3 and 13.2% of patients, respectively, with higher performance rate of retinal screening and urinary microalbumin in T1DM; BMI and blood pressure were recorded for 50.2 and 97.2% of patients, respectively. Prevalence of nephropathy, polyneuropathy, retinopathy, and angiopathy was 8.4, 36.2, 10.7 and 7.7%, respectively, with the higher prevalence in T1DM.
  
  
  CONCLUSIONS
  The analysis revealed good glycaemic control in T2DM, but insufficient in T1DM. Continuous monitoring of diabetes complications and cardiovascular risk factors did not meet the local Diabetes Care Guidelines.
authors.affiliation: Clinic of Internal Diseases, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, Lithuania.|Centre of Endocrinology, Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania.
authors.forename: Žydrūnė
authors.initials: Ž
authors.lastname: Visockienė
authors.affiliation: Centre of Endocrinology, Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania.
authors.forename: Laura
authors.initials: L
authors.lastname: Šiaulienė
authors.affiliation: Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University, Lithuania.|Centre of Informatics and Development, Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania.
authors.forename: Roma
authors.initials: R
authors.lastname: Puronaitė
authors.affiliation: Clinic of Internal Diseases, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, Lithuania.|Internal Diseases Centre, Vilnius University Hospital Santariškių Klinikos Vilnius, Lithuania.
authors.forename: Virginijus
authors.initials: V
authors.lastname: Šapoka
authors.affiliation: Clinic of Internal Diseases, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, Lithuania.|Centre of Family Medicine, Vilnius University Hospital Santariškių Klinikos Vilnius, Lithuania.
authors.forename: Vytautas
authors.initials: V
authors.lastname: Kasiulevičius
keywords: average HbA1c; diabetes mellitus; quality of diabetes care