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

[21]

Leibson C.L., Williamson D.F., Melton III L.J., Palumbo P.J., Smith S.A., Ransom J.E., Schilling P.L., Narayan K.M., Temporal trends in BMI among adults with diabetes, Diabetes Care, 24, pp. 1584-1589, (2001)

[22]

DeWilde S., Carey I.M., Bremner S.A., Richards N., Hilton S.R., Cook D.G., Evolution of statin prescribing 1994-2001: A case of agism but not of sexism?, Heart, 89, (2003)

[23]

Gudbjornsdottir S., Cederholm J., Nillson P.M., Eliasson B., The national diabetes register in Sweden: An implementation of the St. Vincent declaration for quality improvement in diabetes care, Diabetes Care, 26, pp. 1270-1276, (2003)

[24]

De Grauw W.J.C., Van Gerwen W.H.E.M., Van De Lisdonk E.H., Van Den Hoogen H.J.M., Van Den Bosch W.J.H.M., Van Weel C., Outcomes of audit-enhanced monitoring of patients with type 2 diabetes, J Fam Pract, 51, pp. 459-464, (2002)

[25]

DeWilde S., Carey I.M., Bremner S.A., Richards N., Hilton S.R., Strachan D.P., Cook D.G., A comparison of the recording of 30 common childhood conditions in the Doctors Independent Network and General Practice Research Databases, Health Statistics Quarterly, 22, pp. 21-30, (2004)

[26]

Hammersley V., Hippisley-Cox J., Wilson A., Pringle M., A comparison of research general practices and their patients with other practices - A cross-sectional survey in Trent, Br J Gen Pract, 52, pp. 463-468, (2002)

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