Diabetes Care in Rural Area: Clinical and Metabolic Evaluation

Abstract

To evaluate the efficacy of conventional diabetes care in a rural area, metabolic control and the presence of late complications were studied in 622 diabetic patients treated by general practitioners beyond the reach of diabetic centers. Seventy-three (12%) of the patients were classified as type I diabetics (age, 38.0 +/- 16.1 yr; duration of diabetes, 12.8 +/- 9.3 yr) and 549 as type II diabetics (age, 67.0 +/- 10.8 yr; duration of diabetes, 7.3 +/- 5.8 yr). Fifty-eight percent of type I diabetic patients administered insulin once daily and 42% twice daily, whereas most (83%) type II diabetics on insulin received only one insulin injection per day. Treatment of type II diabetic patients consisted of sulfonylureas (58%), diet alone (22%), insulin (18%), and biguanides or a combination of sulfonylurea with biguanides (2%). Poor therapeutic efficacy was observed in all patients, and postprandial hyperglycemia (blood glucose greater than 160 mg/dl) was predominant both in type I diabetics (86%) and in type II diabetics on insulin (80%) as well as off insulin (55%). HbA1c above normal (greater than 5.8%) was seen in 96% of type I and in 90 and 73% of type II diabetics with or without insulin therapy, respectively. Accompanying glucosuria was present in type I (73%) and in type II diabetics (on insulin, 71%; off insulin, 33%). Mean prevalence of late diabetic complications was greatest for insulin-treated patients (type I, type II with, and type II without insulin treatment: retinopathy, 41, 56, 22%; proteinuria, 13, 14, 3%; peripheral neuropathy, 21, 51, 12%), whereas macroangiopathy (16, 53, 31%) predominated in type II diabetic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Quality assessment of diabetes care according to the recommendations of the St. Vincent Declaration: A population-based study in a rural area of Austria

“…In this survey glycaemic control as judged from HbA~o levels compares favourably with respective data from the Wisconsin study [11] and other reports [14,15,22]. Nevertheless, the frequency of severe hypoglycaemia was consistent with comparable data from other studies [23,24], i.e.…”

“…Among the few studies that exist [10][11][12]14,15] the Wisconsin study from the United States is the most comprehensive [10][11][12]. However, the method used for case ascertainement in that study yielded a diabetes prevalence of only 1% [10], a certain underestimation in the light of a recent survey from Minnesota reporting rates of about 8 % for Type 2 (non-insulin-dependent) diabetes [13].…”

“…In addition, patients institutionalized in nursing homes and disability centres were not evaluated [10]. Likewise, in two smaller European studies [14,15] estimated prevalence rates of diabetes were less than 2 %, again indicating bias in patient selection. The differences in the completeness of patient recruitment have to be taken into account when comparisons are made between the findings of the present investigation and other studies.…”

Incidence of patients presenting with exudative maculopathy and neovascular retinal disease in an urban population

“…Thus, extrapolating our data, within one year 736 patients of 100,000 (0.7%) are referred with PDR and/or DME to tertiary centers for treatment. This incidence seems comparable to the data of other epidemiologic studies [16,37].…”

Gesundheitsstatus der Typ-2-Diabetiker in Österreich aus der Sicht einer Qualitätssicherungs-Initiative

“…Fax: þþ43-316-876 21 30, E-Mail: ivo.rakovac@joanneum.atIn der CODE-2-Studie[2] wurde im Jahr 2002 die Pr€ avalenz der diabetesspezifischen Komplikationen bestimmt und die krankheitsspezifischen Kosten in acht europ€ aischen L€ andern (Belgien, Frankreich, Deutschland, Holland, Italien, Spanien, Schweden und England) ermittelt. Die Pr€ avalenz der diabetesassoziierten Komplikationen in Österreich wurde bisher nur in drei kleineren Studien erhoben[3][4][5]. Aufgrund des Alters dieser Publikationen sowie die relativ kleinen Zahl der untersuchten Patienten ist eine aktuelle Ermittlung der diabetesspezifischen Komplikationen von Interesse, um bessere Einblicke in den derzeitigen Gesundheitsstatus der Typ-2-Diabetiker in Österreich zu gewinnen.Ziel dieser Arbeit ist es, aktuelle Daten über die Pr€ avalenz der diabetesspezifischen Komplikationen in Österreich zu ermitteln.…”