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International Journal for Quality in Health Care 15:301-307 (2003)
© 2003 International Society for Quality in Health Care

Outcomes of diabetes care: a population-based study

LISBETH M. FÄRNKVIST1 and BERIT M. LUNDMAN2,

1 Research and Development Unit, Primary Health Care, Sundsvall, Sweden
2 Department of Nursing, Umeå University, Umeå, Sweden

Aims. To describe prevalence, metabolic control, and complications of diabetes mellitus in a county in Northern Sweden, in order to improve diabetes care and guide decision makers.

Methods. A population-based, cross-sectional, retrospective study of medical records of all registered persons with diabetes mellitus (n = 5251) in the area. Assessments and examinations concerning metabolic control and complications were studied over a period of 15 months.

Results. Of the 5143 patients included, 13% had Type 1, 86% Type 2, and 1% other types of diabetes. An annual check-up was performed in 84% of patients. Glycosylated haemoglobin (HbA1c) was assessed in 88%, and had a mean value of 7.3% (sd 1.3%). Metabolic control was good in 33% and acceptable in another 26%. Risk factors for complications were found in 64%; in 35% body mass index was >30; 50% had hypertension; 22% were smokers; 51% had macro- and/or microvascular complications; ischaemic heart disease 26%; a cerebrovascular lesion 13%; amputation 1.8%; proteinuria 7.9%; microalbuminuria 2.6%; peripheral neuropathy 30%; impaired peripheral circulation 29%; and retinopathy 37%.

Conclusions. The majority of patients with diabetes in the study area attended an annual check-up, had acceptable metabolic control and severe complications were uncommon. Nevertheless, the number of undocumented examinations was high, 40% of the patients had unacceptable metabolic control and more than 50% had macrovascular risk factors. These findings emphasize the importance in diabetes care of smoking cessation and intensive treatment of high blood pressure.

Keywords: complications, diabetes mellitus, metabolic control, population-based study, quality of care

Address reprint requests to Berit Lundman, Department of Nursing, Umeå University, S-901 87 Umeå, Sweden. E-mail: Berit.Lundman{at}nurs.umu.se

Accepted for publication March 31, 2003.


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