BACKGROUND. Although the glycaemic targets have been clearly defined, the percentage of the patients metabolically well controlled is progressively decreasing. The cause of this condition may be a growing number of the patients with diabetes, the lack of possibilities to provide all all of them with specialist care as well as difficulties to implement recommendations of the Polish Diabetes Association concerning the so called “shared care”. The aim of this study was the evaluation of metabolic control in type 2 diabetic patients treated in primary care settings and referred to specialist within the scope of the project “the Improvement of Glycaemic Control”.
MATERIAL AND METHODS. The analysis was performed in 5812 type 2 diabetic patients included into “The Improvement of Glycaemic Control” programme and treated by general practitioners. The inclusion criteria were: treatment with oral hypoglycaemic agents in maximal doses and/or with insulin, fasting glycaemia > 150 mg/dl, 2-hour postprandial glycaemia > 200 mg/dl. Body mass index (BMI), HbA_1c level, blood pressure and lipids were assessed. The patients were referred to specialists when HbA1c > 8% in order to modify antidiabetic treatment and educate.
RESULTS. The mean HbA_1c value was 8,8%. HbA_1c < 7% was in 18,5% patients. Mean blood pressure was 140/83 mm Hg. 32,9% patients had target values of LDL, 27,5% patients of total cholesterol, 71,1% patients of HDL and 17,6% patients of triglycerides. BMI was 32 ± 5.5 kg/m², 7,5% patients had normal BMI, 38,5% were overweight, and 54% were obese.
CONCLUSIONS. The obtained results indicate insufficient metabolic control in type 2 diabetic patients referred by GP’s to specialists. The data point to the need of integrated, shared care which enables implementation of the assumed therapeutic aims in a full and complex way.