DIABETES MANAGEMENT IN CELJE GENERAL HOSPITAL

  • Gregor Veninšek Oddelek za endokrine bolezni in bolezni presnove, Splošna bolnišnica, Oblakova 5, 3000 Celje
Keywords: epidemiology of diabetes, prevalence of risk factors, prevalence of chronic complications of diabetes, metabolic control, distribution of treatment modalities of diabetes, caracteristics of newly registered diabetics

Abstract

Background. The prevalence of diabetes is growing. Development of chronic complications of diabetes can be prevented by intensive treatment. It is of utmost importance to know characteristics of treated population to follow it up and adjust measures. We conducted an evaluation of population of diabetic patients treated in Celje General Hospital.

Methods. We studied 156 outpatients treated in Celje General Hospital in January 2000. We collected data on basic anthropologic characteristics, data on type, duration and treatment modality of diabetes, metabolic parameters, risk factors for developement and presence of chronic complications. We specially presented a subgroup of diabetics treated in our outpatient service less than two years.

Results. The mean age of patients was 58 years. They have been treated for diabetes in average for 10 years. 94% of patients were type 2. 3% of patients had secondary diabetes and 3% had type 1 diabetes. 74% were overweight. 37% of patients had HbA1c equal or below 7.5%, 45% of patients had LDL equal or below 3.0 mmol/l, and 52% of patients had blood pressure equal or below 140/90 mmHg. Retinopathy was present in 34%, renal failure in 10% and neuropathy in 35%. Amputation on a lower limb had had 1% of patients. 56% of patients were treated only with oral hypoglycaemic drugs, 6% diet only and 38% of patients were treated with insulin either alone or in combination with oral hypoglycaemic drugs. In diabetics that we treat less than two years at least one late complication was present in 73%.

Conclusions. Diabetics are referred to our service when complications of treatment of diabetes or chronic complications of diabetes are present. In the beginning of year 2000 we achieved acceptable value of HbA1c in 37% of patients, that of LDL and blood pressure in 45% and 52%, respectively. Prevalence of chronic complications of diabetes was comparable with the data from the literature.

Downloads

Download data is not yet available.

References

King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates and projections. Diabetes Care 1998; 21: 1414–31.

Klein R, Klein BE, Moss SE, Davis MD, De Mets DL. The Wisconsin epidemiologic study of diabetic retinopathy. X. Four-year incidence and progression of diabetic retinopathy when age at diagnosis is 30 years or more. Arch Ophtalmol 1989; 107: 244–9.

Paisey RB, Arredondo G, Villalobos A et al. Association of differing dietary, metabolic, and clinical risk factors with macrovascular complications of diabetes: a prevalence study of 503 Mexican type II diabetic subjects. Diabetes Care 1984; 7: 421–7.

Delcourt C, Vauzelle-Kervroedan F, Cathelineau G, Papoz L. Low prevalence of long-term complications in non-insulin dependent diabetes mellitus in France: a multicenter study. J Diabetes Complications 1998; 12: 88–95.

Cabezas-Cerrato J. The prevalence of clinical diabetic polyneuropathy in Spain: a study in primary care and hospital clinic groups. Diabetologia 1998; 41: 1263–9.

Kuzuya T, Akanuma Y, Akazawa Y, Uehata T. Prevalence of chronic complications in Japanese diabetic patients. Diabetes Res Clin Pract 1994; 25: Suppl 24: 159S–64S.

Gall MA, Rossing P, Skott P et al. Prevalence of micro- and macroalbuminuria, arterial hypertension, retinopathy and large vessel disease in European type 2 (non-insulin dependent) diabetic patients. Diabetologia 1991; 34: 655–61.

Thai Multicenter Research Group on Diabetes. Vascular complications in non-insulin dependent diabetics in Thailand. Diabetes Res Clin Pract 1994; 25: 61–9.

Lundman B, Engström L. Diabetes and its complications in a Swedish country. Diabetes Res Clin Pract 1998; 39: 157–64.

Klein R, Klein BEK. Vision disorders in diabetes. In: Harris MI, Cowie CC, Reiber G, Boyko EJ, Stern M, Bennett P eds. Diabetes in America. 2nd ed. Washington, DC: U.S. Govt. Printing Office, 1995: 293–338.

Nelson RG, Knowler WC, Pettitt DJ, Bennett PH. Kidney diseases in diabetes. In: Harris MI, Cowie CC, Reiber G, Boyko EJ, Stern M, Bennett P eds. Diabetes in America. 2nd ed. Washington, DC: U.S. Govt. Printing Office, 1995: 349–94.

Reiber GE, Boyko EJ, Smith DG. Lower extremity foot ulcers and amputations in diabetes. In: Harris MI, Cowie CC, Reiber G, Boyko EJ, Stern M, Bennett P eds. Diabetes in America. 2nd ed. Washington, DC: U.S. Govt. Printing Office, 1995: 409–28.

DCCT Research group. The effect of intensive treatment of diabetes on development and progression of long-term complications in insulin-dependant diabetes mellitus. N Engl J Med 1993; 329: 977–86.

UK Prospective Diabetes Study Group. Intensive blood-glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352; 837–53.

UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes (UKPDS 38). Br Med J 1998; 317: 703–13.

Jawitt JC, Chiang YP. Economic impact of diabetes. In: Harris MI, Cowie CC, Reiber G, Boyko EJ, Stern M, Bennett P eds. Diabetes in America. 2nd ed. Washington, DC: U.S. Govt. Printing Office, 1995: 601–12.

Herman WH, Dasbach EJ, Songer TJ, Eastman RC. The cost-effectiveness of intensive therapy for diabetes mellitus. Endocrinol Metab Clin North Am 1997; 26: 679–95.

Gray A, Raikou M, McGuire A et al. Cost effectiveness of an blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41). Br Med J 2000; 320: 1373–8.

Koselj M, Medvešček M, Mrevlje F eds. Sladkorna bolezen tipa 2. Priročnik za zdravnike. Ljubljana: samozaložba, 1999: 3–10.

Kocijančič A, Mrevlje M eds. Interna medicina. Ljubljana: EWO; DZS, 1998: 547–7.

Koselj M, Medvešček M, Mrevlje F eds. Sladkorna bolezen tipa 2. Priročnik za zdravnike. Ljubljana: samozaložba, 1999: 19–24.

Wood D. European and American recommendations for coronary heart disease prevention. Eur Heart J 1998; 19: Suppl A: 12A–9A.

Kocijančič A, Mrevlje F eds. Interna medicina. Ljubljana: EWO; DZS, 1998: 189–222.

UK Prospective Diabetes Study Group. Complications in newly diagnosed type 2 diabetic patients and their association with different clinical and biochemical risk factors (UKPDS 6). Diabetes Research 1990; 13: 1–11.

How to Cite
1.
Veninšek G. DIABETES MANAGEMENT IN CELJE GENERAL HOSPITAL. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];70. Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/2512
Section
Professional Article