Biochemical profiling,pharmacological management and clinical outcomes in type 2 diabetes in Danish primary care from 2001 to 2015 |
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| Affiliation: | 1. Steno Diabetes Center Copenhagen, Herlev, Denmark;2. Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;3. Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark;4. Department of Hematology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark;5. Department of Public Health, University of Copenhagen, Copenhagen, Denmark;1. Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Bengaluru, India;2. Department of Clinical Research, ICMR- National Institute for Research in Tuberculosis, Chennai, India;3. Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, USA;4. Department of Psychiatry, St John''s Medical College Hospital, Bengaluru, Karnataka, India;5. Division of Mental Health and Neurosciences, St. John''s Research Institute, St. John''s National Academy of Health Sciences, Bengaluru, Karnataka, India;1. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA;2. Emory Global Diabetes Research Center of Emory University and Woodruff Health Sciences Center, Atlanta, USA;1. People’s Medical College and Research Centre, Bhopal, India;2. Director Hormone & Skin Centre, Bhopal, India;1. India Diabetes Research Foundation and Dr. A. Ramachandran''s Diabetes Hospitals, Chennai, India;2. ARH Digital Services, Chennai, India;1. Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran;4. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;1. Center of Comprehensive Care of the Patient with Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Vasco de Quiroga No. 15, Colonia Belisario Dominguez Sección XVI, Tlalpan, Mexico City 14080, Mexico;2. Faculty of Medicine, Universidad Nacional Autónoma de México, Circuito Escolar 411 A, Copilco Universidad, Coyoacán, 04360 Mexico CIty, Mexico;3. Endocrinology and Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Vasco de Quiroga No. 15, Colonia Belisario Dominguez Sección XVI, Tlalpan, Mexico City 14080, Mexico;4. Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Vasco de Quiroga No. 15, Colonia Belisario Dominguez Sección XVI, Tlalpan, Mexico City 14080, Mexico;5. Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, 62100 Cuernavaca, Morelos, Mexico;6. Direction of Nutrition, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Vasco de Quiroga No. 15, Colonia Belisario Dominguez Sección XVI, Tlalpan, Mexico City 14080, Mexico |
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| Abstract: | AimsPrimary care plays an integral role in the management of type 2 diabetes (T2D). We investigated in a large group of individuals in this setting the biochemical profiles, pharmacological management and clinical outcomes as well as their changes over time.MethodsThis is a register-based study including relevant laboratory test results requested between 2000 and 2015 by general practitioners in the greater Copenhagen area. We identified 72,044 individuals with T2D on whom data concerning prescription medicine and clinical outcomes were obtained from national registries.ResultsThe number of individuals with T2D greatly increased from 2001 to 2015. Hemoglobin A1c, estimated glomerular filtration rate and urine albumin creatinine ratio did not change, but cholestrol levels improved. The proportion redeeming anti-diabetics remained around 80%, with an increase for metformin. The use of cardiovascular drugs increased. All-cause and especially cardiovascular mortality decreased over the period. Hospital admissions for non-fatal cardiovascular events dropped.ConclusionThe number of individuals with T2D in primary care increased dramatically whereas pharmacological management, control of risk factors and clinical outcomes seem to have improved. Nevertheless, a conspicuous minority did not receive diabetes-related medication. |
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| Keywords: | Primary care Type 2 diabetes Medications Clinical outcomes Register study |
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