Vol 8, No 8-9 (2007): Practical Diabetology
Research paper
Published online: 2007-09-08
Management of diabetes mellitus in patients with type 2 diabetes residing in a rural district of westpomeranian province
Diabetologia Praktyczna 2007;8(8-9):295-300.
Abstract
INTRODUCTION. The great majority of patients with
type 2 diabetes, which accounts for 95% of all dia betic subjects, are treated only by general practitioners,
especially in rural areas. The UKPDS study demonstrated
that a better control of type 2 diabetes
considerably reduces the risk of chronic diabetic complications.
The main goal of the study was to assess
metabolic control in type 2 diabetes patients, residents
of a rural district of Westpomeranian Province.
MATERIAL AND METHODS. The study was conducted in the General Practitioner’s Clinic NZOZ „Asklepios” in Bobolice, who provides medical care for 279 diabetics who account for 3.3% of all registered subjects. All diabetic patients were invited to participate in the study, and 249 subjects volunteered (89%). The age of investigated subjects ranged from 32 to 91 years (mean 66.5 ± 12.4 years). The mean body mass index (BMI), calculated for 174 patients, was 32.3 ± 6.4 kg/m². In the morning after an overnight fast, in all participants venous blood samples were taken for measurement of HbA1c and serum glucose level.
RESULTS. The mean HbA1c level was 7.82 ± 1.95% and mean fasting serum glucose 156 ± 66 mg/dl. Values of HbA1c ≥ 6.5% were observed in 31% of participants. Recommended glucose level £ 110 mg/dl was observed in 25% patients. Only in 17% of subjects both parameters, HbA1c and fasting glycaemia met the criteria recommended by Polish Diabetes Association 2007. Values of HbA1c < 7%, recommended by the American Diabetes Association (ADA) were observed in 38% of subjects while fasting glycaemia 90-130 mg/dl in 37% of cases. Both criteria, recommended by the ADA were met in 22% of diabetic patients. Obtained results were compared with the published data concerning outpatients’ clinics from urban areas.
CONCLUSION. Metabolic control of type 2 diabetic subjects, residents of the rural area in North-West part of Poland, is unsatisfactory and seems to be worse than in the patients from urban areas. This may be a result of higher degree of obesity and overweight of these patients as well as worse access to specialist care.
MATERIAL AND METHODS. The study was conducted in the General Practitioner’s Clinic NZOZ „Asklepios” in Bobolice, who provides medical care for 279 diabetics who account for 3.3% of all registered subjects. All diabetic patients were invited to participate in the study, and 249 subjects volunteered (89%). The age of investigated subjects ranged from 32 to 91 years (mean 66.5 ± 12.4 years). The mean body mass index (BMI), calculated for 174 patients, was 32.3 ± 6.4 kg/m². In the morning after an overnight fast, in all participants venous blood samples were taken for measurement of HbA1c and serum glucose level.
RESULTS. The mean HbA1c level was 7.82 ± 1.95% and mean fasting serum glucose 156 ± 66 mg/dl. Values of HbA1c ≥ 6.5% were observed in 31% of participants. Recommended glucose level £ 110 mg/dl was observed in 25% patients. Only in 17% of subjects both parameters, HbA1c and fasting glycaemia met the criteria recommended by Polish Diabetes Association 2007. Values of HbA1c < 7%, recommended by the American Diabetes Association (ADA) were observed in 38% of subjects while fasting glycaemia 90-130 mg/dl in 37% of cases. Both criteria, recommended by the ADA were met in 22% of diabetic patients. Obtained results were compared with the published data concerning outpatients’ clinics from urban areas.
CONCLUSION. Metabolic control of type 2 diabetic subjects, residents of the rural area in North-West part of Poland, is unsatisfactory and seems to be worse than in the patients from urban areas. This may be a result of higher degree of obesity and overweight of these patients as well as worse access to specialist care.
Keywords: type 2 diabetesrural areametabolic controlHbA1cfasting glycaemia