Trends in the prevalence and management of diagnosed type 2 diabetes 1994-2001 in England and Wales

被引：63

作者：

Lusignan S. ^{[1
]}

Sismanidis C. ^{[1
]}

Carey I.M. ^{[1
]}

DeWilde S. ^{[1
]}

Richards N. ^{[2
]}

Cook D.G. ^{[1
]}

机构：

[1] Dept. of Community Health Sciences, St. George's Hospital Medical School

[2] CompuFile Ltd., 1 Tannery House, Send, Surrey GU23 7EF, Tannery Lane

来源：

BMC Family Practice | / 6卷 / 1期

关键词：

Body Mass Index; Metformin; Glycaemic Control; Acarbose; General Practice Research Database;

D O I：

10.1186/1471-2296-6-13

中图分类号：

学科分类号：

摘要：

Background: Type 2 diabetes is an important cause of morbidity and mortality. Its prevalence appears to be increasing. Guidelines exist regarding its management. Recommendations regarding drug therapy have changed. Little is known about the influence of these guidelines and changed recommendations on the actual management of patients with type 2 diabetes. This study aims to document trends in the prevalence, drug treatment and recording of measures related to the management of type 2 diabetes; and to assess whether recommended targets can be met. Methods: The population comprised subjects registered between 1994 and 2001 with 74 general practices in England and Wales which routinely contribute to the Doctors' Independent Network database. Approximately 500,000 patients and 10,000 type 2 diabetics were registered in each year. Results: Type 2 diabetes prevalence rose from 17/1000 in 1994 to 25/1000 in 2001. Drug therapy has changed: use of long acting sulphonylureas is falling while that of short acting sulphonylureas, metformin and newer therapies including glitazones is increasing. Electronic recording of HbA1c, blood pressure, cholesterol and weight have risen steadily, and improvements in control of blood pressure and cholesterol levels have occurred. However, glycaemic control has not improved, and obesity has increased. The percentage with a BMI under 25 kg/m2 fell from 27.0% in 1994 to 19.4% in 2001 (p > 0.001). Conclusion: Prevalence of type 2 diabetes is increasing. Its primary care management has changed in accordance with best evidence. Monitoring has improved, but further improvement is possible. Despite this, glycaemic control has not improved, while the prevalence of obesity in the diabetic population is rising. © 2005 Lusignan et al; licensee BioMed Central Ltd.

引用

共 26 条

[1]

Gadsby R., Epidemiology of diabetes, Adv Drug Deliv Rev, 54, pp. 1165-1172, (2002)

[2]

Passa P., Diabetes trends in Europe, Diabetes Metab Res Rev, 18, 3 SUPPL., (2002)

[3]

Newnham A., Ryan R., Khunti K., Majeed A., Prevalence of diagnosed diabetes mellitus in general practice in England and Wales, 1994 to 1998, Health Statistics Quarterly, 14, pp. 5-13, (2002)

[4]

Management of Type 2 Diabetes - Management of Blood Pressure and Blood Lipids (Guideline H)

[5]

Management of Type 2 Diabetes - Managing Blood Glucose Levels (Guideline G)

[6]

Standards of Medical Care in Diabetes, Diabetes Care, 27, (2004)

[7]

National Service Framework for Diabetes, (2003)

[8]

Shekelle P., New contract for general practitioners, BMJ, 326, (2003)

[9]

De Grauw W.J.C., Van De Lisdonk E.H., Van Den Hoogen H.J.M., Van Weel C., Cardiovascular morbidity and mortality in type 2 diabetic patients: A 22-year historical cohort study in Dutch general practice, Diabetic Medicine, 12, pp. 117-122, (1995)

[10]

Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34), Lancet, 352, pp. 854-865, (1998)

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