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Int J Clin Pract. 2019 Jan 21:e13313. doi: 10.1111/ijcp.13313. [Epub ahead of print]

Maintenance of good glycaemic control is challenging - A cohort study of type 2 diabetes patient in North Karelia, Finland.

Author information

1
Department of Public Health, University of Helsinki, Helsinki, Finland.
2
Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.
3
Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland.
4
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
5
Department of Geographical and Historical Studies, University of Eastern Finland, Joensuu, Finland.

Abstract

AIMS:

This study assessed type 2 diabetes treatment outcomes and process indicators using a comprehensive type 2 diabetes patient cohort in North Karelia, Finland, from 2011 to 2016.

METHODS:

Data from all diagnosed type 2 diabetes patients (n = 8429) living in North Karelia were collated retrospectively from regional electronic patient records. We assessed whether HbA1c and low-density lipoprotein (LDL) were measured and managed as recommended.

RESULTS:

The HbA1c measurement rate improved (78% vs 89%) during 2011-2012 and 2015-2016, but a gradual deterioration in glycaemic control (HbA1c < 7.0% or 53 mmol/mol) was observed among both females (75% vs 67%) and males (72% vs 64%). The LDL measurement rate initially improved from the baseline. LDL control (<2.5 mmol/L) improved among both females (52% vs 59%) and males (58% vs 66%). A gender difference was observed in the achievement of the treatment target for LDL, with females showing worse control.

CONCLUSIONS:

Low-density lipoprotein (LDL) control in type 2 diabetes patients has improved, but the existence of gender disparities needs further attention. Maintaining appropriate HbA1c control among type 2 diabetes patients over time appears to be difficult. Active follow-up and tailored treatment have the potential to improve the quality of care. Electronic patient records could be more efficiently used to improve the quality of care and to support decision-making.

PMID:
30664318
DOI:
10.1111/ijcp.13313

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