This population-based survey aimed to determine the prevalence of known diabetes mellitus on 31 December 1986, and to assess all-cause mortality in the subsequent 5 years (1987-1991) in Verona, Italy. In the study of prevalence, 5996 patients were identified by three independent sources: family physicians, diabetes clinics, and drug prescriptions for diabetes. Mortality was assessed by matching all death certificates of Verona in 1987-1991 with the diabetic cohort. Overall diabetes prevalence was 2.61% (95% confidence interval 2.56-2.67). Prevalence of insulin-dependent and non-insulin-dependent diabetes mellitus was 0.069% (0.059-0.078) and 2.49% (2.43-2.54), respectively. Diabetes prevalence sharply increased after age 35 years up to age 75-79, and finally declined. Prevalence was higher in men up to age 69 years, in women after age 75 years. Of the diabetic cohort 1260 patients (592 men, 668 women) died by 31 December 1991, yielding an overall standardized mortality ratio of 1.46 (CI 1.38-1.54). Even though the differences narrowed with age, mortality rates in the diabetic cohort were higher than in the non-diabetic population at all ages. Women aged 65-74 years showed observed/expected ratio higher than men (2.27, CI 1.92-2.66, vs 1.50, CI 1.30-1.72), while in other age groups the sex-related differences were not significant. Pharmacological treatment of diabetes was associated with an excess mortality, while treatment with diet alone showed an apparent protective effect on mortality (observed/expected ratio 0.73, CI 0.58-0.92).(ABSTRACT TRUNCATED AT 250 WORDS)

SummaryThis population-based survey aimed to determine the prevalence of known diabetes mellitus on 31 December 1986, and to assess all-cause mortality in the subsequent 5 years (1987)(1988)(1989)(1990)(1991) in Verona, Italy. In the study of prevalence, 5996 patients were identified by three independent sources: family physicians, diabetes clinics, and drug prescriptions for diabetes. Mortality was assessed by matching all death certificates of Verona in 1987-1991 with the diabetic cohort. Overall diabetes prevalence was 2.61% (95 % confidence interval 2.56-2.67). Prevalence of insulin-dependent and non-insulin-dependent diabetes mellitus was 0.069 % (0.059-0.078) and 2.49 % (2.43-2.54), respectively. Diabetes prevalence sharply increased after age 35 years up to age 75-79, and finally declined. Prevalence was higher in men up to age 69 years, in women after age 75 years. Of the diabetic cohort 1260 patients (592 men, 668 women) died by 31 December 1991, yielding an overall standardized mortality ratio of 1.46 (CI 1.38-1.54). Even though the differences narrowed with age, mortality rates in the diabetic cohort were higher than in the non-diabetic population at all ages. Women aged 65-74 years showed observed/expected ratio higher than men (2.27, CI 1.92-2.66, vs 1.50, CI 1.30-1.72), while in other age groups the sex-related differences were not significant. Pharmacological treatment of diabetes was associated with an excess mortality, while treatment with diet alone showed an apparent protective effect on mortality (observed/expected ratio 0.73, CI 0.58-0.92). In conclusion, in Verona diabetes has a prevalence similar to that of other European countries, and is associated with an excess mortality which is observed in both sexes, at all ages, and with any anti-diabetic pharmacologic treatment. Diet-treated diabetes seems to be associated with a significant reduction in the mortality risk. [Diabetologia (1995) 38: 318-325]

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BackgroundStudies on data collection and quality of care in Italian family medicine are lacking. The aim of this study was to assess the completeness of data collection of patients with diabetes in a large sample of family physicians in the province of Verona, Veneto region, a benchmark for the Italian National Health System.MethodsWe extracted the data on all the patients with diabetes from the electronic health records of 270 family physicians in 2006 and 2009. We reported the percentage of patients with data recorded for 12 indicators of performance derived from the National Institute for Clinical Excellence diabetes guidelines. Secondarily, we assessed quality of care using the Q-score (the lower the score, the greater the risk of cardiovascular events).ResultsPatients with diabetes were 18,507 in 2006 and 20,744 in 2009, and the percentage of patients registered as having diabetes was 4.9% and 5.4% of the total population, respectively (p < 0.001). Data collection improved for all the indicators between 2006 and 2009 but the performance was still low at the end of the study period: patients with no data recorded were 42% in 2006 and 32% in 2009, while patients with data recorded for ≥5 indicators were 9% in 2006 and 17% in 2009. The Q-score improved (mean ± SD, 20.7 ± 3.0 in 2006 vs 21.3 ± 3.6 in 2009, p < 0.001) but most patients were at increased risk of cardiovascular events in both years (Q-score ≤ 20).ConclusionsWe documented an improvement in data collection and quality of care for patients with diabetes during the study period. Nonetheless, data collection was still unsatisfactory in comparison with international benchmarks in 2009. Structural interventions in the organization of family medicine, which have not been implemented since the study period, should be prioritised in Italy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2508-5) contains supplementary material, which is available to authorized users.

This paper synthesizes a six year collaboration between a natural family planning (NFP) non-governmental organization (NGO) and the National Health Service of the Emilia Romagna region in Italy. It also compares the public program experience with NFP services provided in the private sector in the adjacent region of Veneto. Midwives provided NFP services in government family health clinics while in the private sector NFP was taught by non-health laypersons in a church-based facility. The populations served by these two programs were different. Women in the public sector were slightly older and two-thirds were married. Forty percent of the clients had chosen to use NFP to achieve a pregnancy. The private sector client, recruited in part through premarriage counseling programs, was equally divided between married and single women, though the majority came for advice on avoiding or spacing pregnancies. In both regions NFP users were more highly educated than the general population.