Results of the lnternational Diabetes Management Practices Study (IDMPS), year 2: compliance with international guidelines of the management of patients with type 2 diabetes

GAGLIARDINO JJ; ON BEHALF OF THE LDMPS GROUP

Amsterdam

Congreso; 43rd EASD Annual Meeting of the European Association for the Study of Diabetes; 2007

European Association for the Study of Diabetes

Background and Aims: Despite the recommendations of the ADA, EASD and IDF, a large number of people with diabetes are not well controlled. In this regard, our aim was to gather data on cunent practices in management of people 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, the Middle East and Latin America. Data are being collected from people with Type 1 and Type 2 diabetes (¡Ý18 years), seen in current medical praclice 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 people with Type 2 diabetes collected during the second cross-sectional period (Year 2) in 8 countries. In addition to measuring the degree of glucose metabolism control, information about patient education, care delivery and monitoring were collected. Data were analyzed using standard descriptive methods. Results: 4312 people with Type 2 diabetes (48% men; mean age: 58.3¡À 11.2 years), were recruited during November and December 2006. The mean BM1 was 27.4¡À4.4 kg/m2 for men and 28.4¡À5.6 kg/m2 for women. In the past 3 months, patients had visited a specialist in diabetes 1.5¡À1.7 (median: 1.0) times and a GP 0.9¡À1.5 (median: 0; range: 0-20) times. Diabetes education was provided by diabetes educators to 35% of patients (49% of insulin-treated patients), 2.9¡À4.1 (median: 2.0) times within the last 12 months, and was individual in 72. 1 % of patients being trained. Only 76% of patients had HbA1c tested at least once with a mean of 2.0¡À1.2 (median: 2.0) tests within the past year. The mean HbA1c was 8.0¡À2.0%. Moreover, only 33% of patients had an HbA1c <7%. Laboratory testing for FBG was performed 5.3¡À7.3 (median: 4.0) times/year. The mean FBG (laboratory) was 158.8¡À64.0 mg/dL and only 13% of patients had a FBG ¡Ü100 mg/dL. Among patients receiving insulin (alone or in combination with oral glucose lowering drugs (OGLD)), 67% had a glucometer at home and 69% self-monitored their blood glucose (SMBG); FBG was monitored by SMBG 11.3¡À10.7 (median: 8.0) times/month and post-prandial glucose 7.9¡À9.3 (median: 4.0) times/month. Target treatment levels were achieved for blood pressure in 20% of patients, for LDL(<100 mg/ dL) in 33%, for HDL (>40 mg/dL) in 62%, and for triglycerides (<150 mg/ dL) in 54%. The percentage of patients screened for diabetes complications is given in the Table. Table. Frequency of screening for diabetes complications.                                   Screened at least once         Never tested                                   within the past year Lipid abnormalilies                  61%                            15% Lipid abnormalilies                  61%                            15% Cardiovascular disease            51%                            21%  Microalbuminuria                    47%                            33% Retinopathy                             47%                            29% Neuropathy                             47%                            36.% Diabetic foot ulcer                   46%                            38% Conclusion: Our data show that the current management practices of people with Type 2 diabetes poorly complies with most international guidelines. This suggests that improvement of education and commitment of both patients and their care providers is necessary to achieve a more interactive and effective care provision to these patients. Conclusion: Our data show that the current management practices of people with Type 2 diabetes poorly complies with most international guidelines. This suggests that improvement of education and commitment of both patients and their care providers is necessary to achieve a more interactive and effective care provision to these patients. Supported by an unrestricted grant from sanofi-aventis