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Nutr Metab Cardiovasc Dis. 2008 Jan;18(1):57-65. Epub 2006 Jul 24.

Quality of diabetes care predicts the development of cardiovascular events: results of the QuED study.

Author information

1
Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale 8/A, 66030 S. Maria Imbaro (CH), Italy.

Abstract

BACKGROUND AND AIM:

In the context of the QuED Study we assessed whether a quality of care summary score was able to predict the development of cardiovascular (CV) events in patients with type 2 diabetes.

METHODS AND RESULTS:

The score was calculated using process and intermediate outcome indicators (HbA1c), blood pressure, low-density lipoprotein cholesterol, microalbuminuria) and ranged from 0 to 40. Overall, 3235 patients were enrolled, of whom 492 developed a CV event after a median follow-up of 5 years. The incidence rate (per 1000 person-years) of CV events was 62.4 in patients with a score < or =10, 54.8 in those with a score between 15 and 20, and 39.8 in those with a score >20. In adjusted multilevel regression models, the risk to develop a CV event was 89% greater in patients with a score of < or =10 (rate ratio [RR]=1.89; 95% confidence interval [CI] 1.43-2.50) and 43% higher in those with a score between 10 and 20 (RR=1.43; 95% CI 1.14-1.79), as compared to those with a score >20. A difference between centers of 5 points in the mean quality score was associated with a difference of 16% in CV event risk (RR=0.84; 95% CI 0.72-0.98).

CONCLUSION:

Our study documented for the first time a close relationship between a score of quality of diabetes care and long-term outcomes.

PMID:
16860547
DOI:
10.1016/j.numecd.2006.04.009
[Indexed for MEDLINE]

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