Management of Chinese patients with type 2 diabetes, 1998-2006: the Diabcare-China surveys

Objective: To describe and compare the differences in subject characteristics, glycaemic control, diabetes complications, and treatment between 1998 and 2006 in patients with type 2 diabetes. Research design and methods: Subjects who had been registered for diabetes care at the diabetes clinic (defined as any clinic treating over 100 patients/month) for over 12 months were enrolled. The data were retrospectively reviewed, including diabetes history, treatment regimens and laboratory assessments. HbA(1c) was measured at a central laboratory. All data were tabulated and statistical analyses were performed. Results: The Diabcare studies included 2246 subjects (mean age: 59.7 years) in 1998 and 2702 subjects (mean age: 61.9 years) in 2006. The mean duration of diabetes was 8.2 years in 1998 and 8.7 years in 2006 and mean BMI was 23.8 kg/m(2) in 1998 and 24.6 kg/m(2) in 2006. The mean glycaemic control improved significantly from 1998 (8.7 +/- 2.0%) to 2006 (7.6 +/- 1.6%) and significantly more patients reached HbA(1c) <7% or <= 6.5% in 2006. The mean fasting plasma glucose (FPG) values were 9.0 +/- 3.4 mmol/L in 1998 and 7.7 +/- 2.5 mmol/L in 2006. From 1998 to 2006, cataract, neuropathy and background retinopathy remained the most frequently observed diabetes complications. The percentage of the subjects treated with oral antidiabetic drugs (OADs) alone decreased from similar to 75% in 1998 to similar to 50% in 2006, while the proportion of patients on insulin only and on OADs in combination with insulin was greater in 2006 than 1998. The majority of subjects rated their quality of life as good or acceptable in 2006. Conclusion: Glycaemic control, diabetes therapy and patient care were improved in 2006. However, the gap between therapeutic guidelines and glycaemic control strongly suggests that promoting awareness of treat-to-target treatment and continuing medical education in clinical practice are still needed.