Blood glucose control and quality of health care in non-insulin-treated patients with Type 2 diabetes in Spain: a retrospective and cross-sectional observational study

• Published in: Diabetic medicine 2011-06, Vol.28 (6), p.731-740
• Main Authors: Rodríguez, A., Calle, A., Vázquez, L., Chacón, F., Polavieja, P., Reviriego, J.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Blood Glucose Self-Monitoring; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; glycaemic control; glycated haemoglobin; Glycated Hemoglobin A - drug effects; Humans; hyperglycaemia; Hyperglycemia - blood; Hyperglycemia - drug therapy; Hyperglycemia - epidemiology; hypoglycaemic agents; insulin resistance; Male; Medical sciences; Middle Aged; Original; Patient Compliance; Quality Assurance, Health Care; Retrospective Studies; Spain - epidemiology; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2011.03258.x

Diabet. Med. 28, 731–740 (2011) Aims  To assess blood glucose control and quality of health care provided to non‐insulin‐treated patients with Type 2 diabetes mellitus in routine clinical practice in Spain. Methods  In this observational, retrospective, cross‐sectional study, patients were grouped as either having good or suboptimal blood glucose control according to International Diabetes Federation or American Diabetes Association HbA1c goals. Clinical and socio‐demographic data and compliance with the main standard level of care recommendations of the International Diabetes Federation were recorded during a routine visit. Correlates of glucose control were analysed by logistic regression. Results  Many patients were grouped as having suboptimal control under International Diabetes Federation (61.9%) or American Diabetes Association (45.0%) criteria. The mean number of accomplished International Diabetes Federation recommendations (7.3 out of 11) was higher for endocrinologists (than for internists or primary care physicians), and significantly more patients under their care were in the good glucose control group (than with primary care physicians). More recommendations were associated with blood glucose control using International Diabetes Federation than American Diabetes Association criteria, demanding higher quality of health care for achieving stricter goals. Some recommendations were poorly observed, particularly those concerning patients’ education on diabetes, the prompt prescription of effective treatments and monitoring of complications. Diabetes complications were associated with being in the suboptimal control group. Patients’ education on diabetes and HbA1c monitoring were associated with being in the good control group. Conclusions  These results demonstrate the need for improvement in the management of patients with non‐insulin‐treated Type 2 diabetes in actual clinical practice in Spain. Such improvement would entail a stricter adherence to International Diabetes Federation recommendations.