Results of the International Diabetes Management Practices Study (IDMPS), year 2: pattern of care in patients with type 2 diabetes

ILKOVA H; GAGLIARDINO JJ; ON BEHALF OF THE LDMPS GROUP

Amsterdam

Congreso; 43rd EASD Annual Meeting; 2007

European Association for the Study of Diabetes

Background and Aims: Despite the recommendations of the ADA, EASD and IDF, a large number of patients with diabetes are not well controlled, emphasizing the need for implementation of measures designed to improve the quality of diabetes care. In this regard, our aim was to gather data on current practices in the management of patients with diabetes worldwide and to evaluate the degree of compliance with international guidelines. Material and Methods: The IDMPS is an international, multicenter, observational study performed in 27 countries within Africa, Asia, Eastern Europe, Middle East and Latin America. Data are being collected from patients with Type 1 and Type 2 diabetes (218 years), seen in current medical practice in l-year cycles (a 2-week cross-sectional recruitment period, followed by a 9-month longitudinal period for Type 2 patients) for 5 years. Here, we report results for patients with Type 2 diabetes collected during the second cross-sectional period (Year 2) in 8 countries. To measure the degree of glucose metabolism control, HbA1c and fasting blood glucose (FRG) values were collected. Data were anaIyzed using standard descriptive methods. Results: 4312 patients with Type 2 diabetes (47.8% men; mean age: 58.3±11.2 years), were recruited during November and December 2006. The mean BMI was 27.4±4.4 kg/m2 for men and 28.4±5.6 kg/m2 for women. In the past 3 months, patients had visited a specialist in diabetes 1.5±1.7 (median: 1.0) times and a GP 0.9±1.5 (median: 0; range: 0-20) times. In 23.6% of patients, HbA1c was never tested; 76.4% of patients had HbA1c tested at least once with a mean of 2.0±1.2 (median: 2.0) tests within the past year; the mean time elapsed since the last HbA1c measurement was 2.8±5.5 (median: 1.0) months. The mean last available HbA1c was 8.0±2.0%. 32.7% of patients had an HbA1c <7%, 26.5% between 7% and 8%, and 40.8 >8%. Laboratory testing for FBG was performed 5.3±7.3 (median: 4.0) times/year. Mean FBG (laboratory) was 158.8±64.0 mg/ dL and 12.7% had a FBG ~ 100 mg/dL. Among patients receiving insulin (alone or in combination with oral glucose lowering drugs (OGLD)), 67.0% had a glucometer at home, 68.6% self-monitored their blood glucose (SMBG), and FBG was being monitored by SMBG 11.3±10.7 (median:8.0) times/month and post-prandial glucose 7.9±9.3 (median: 4.0) times/month. 37.3% of patients were considered to be on target according to the physician´s opinion; among these 79.9% were tested and had a mean HbA1c of 6.7±1.3%. Conclusion: Our data show that 1/3 of patients with Type 2 diabetes are controlled (in terms of HbA,) as shown in DECODE and NHANES studies. This highlights that a more interactive and effective care provision has to be actively pursued to ameliorate the glycemic control of patients with Type 2 diabetes. Supported by an  unrestricted grant from sanofi-aventis