The association between glycemic, lipids and blood pressure control among Israeli diabetic patients

Background: It is recommended that in diabetes mellitus patientsall risk factors for cardiovascular disease should be controlled. Aim: To evaluate the rate of reaching all glycemic, lipids andblood pressure target levels among diabetic patients in Israeland to analyze demographic and clinical parameters associatedwith it. Design: A cross-sectional study. Methods: The study was conducted in Maccabi Healthcare Services,Israel's second largest health maintenance organization. Allpatients (n = 41 936), older than 20 years, who were listedon Maccabi Healthcare Service's diabetes mellitus computerizeddatabase and had all three study parameters (HbA1c, LDL-C andblood pressure levels during 2005) were eligible for the study.The rate of reaching HbA1c <7.0%, LDL-C <100 mg/dl andblood pressure <130/85 mmHg, as well as its association withvarious demographic and clinical parameters were analyzed. Results: Only 13% of all study patients achieved all three targetlevels. The parameters which were significantly associated withgoal achievement were compliance to medical treatment for allthree parameters (OR 1.56, 95% CI 1.44–1.69, P = 0.0001),male gender (OR 1.42, 95% CI 1.31–1.54, P = 0.0001), comorbiditywith ischemic heart disease (OR 1.23, 95% CI 1.13–1.34,P = 0.0001), and >12 visits per year to family physician(OR 1.10, 95% CI 1.02–1.19, P = 0.012). Conclusion: Non-compliance with treatment and sub-optimal follow-upby family physicians are associated with increased risk of failureto control major risk factor among diabetic patients.