Literature DB >> 19358093

Type 2 diabetes in primary care in belgium: need for structured shared care.

G Goderis1, L Borgermans, J Heyrman, C Van Den Broeke, R Grol, B Boland, C Mathieu.   

Abstract

OBJECTIVE: To picture the profile of type 2 diabetic patients in Belgium and to study the quality of care in the primary care setting, with regard, to multi-factorial approach of the disease.
METHODS: Observational study of all known DM2-patients registered by 120 volunteer general practitioners. Quality of care was evaluated by the achievement of three major treatment targets: HbA1c<7%; Systolic Blood Pressure </=130 mmHg; LDL-Cholesterol<100 mg/dl (ADA 2003). Multivariate analysis was performed.
RESULTS: 2495 DM2-patients were included with a mean age of 68+/-12 years and 51% being women. One fifth of the patients had microvascular complications and 27% had macrovascular complications. Sixty-eight percent received oral anti-diabetic drugs and 19% were on insulin. Satisfactory glycaemic control (HbA1c<7%) was achieved in 54% of the patients, with however glucose control deteriorating with disease progression despite more intensive hypoglycaemic treatment. Systolic blood pressure targets were reached in 50%. Statin use was present in 39% and LDL levels<100 mg/dl were reached in 42%. 59% of insulin treated patients were followed up in shared care with specialised diabetes centres. These patients obtained lower values for HbA1c (7.5+/-1.2% vs. 7.8+/-1.5%, p=0.038) and LDL-C (90+/-34 vs. 111+/-37, p<0.001) compared to insulin-treated patients only followed up in primary care.
CONCLUSION: Overall metabolic control in type 2 diabetic patients in primary care in Belgium was acceptable for glucose control, but major room for improvement exists especially for statin use and blood pressure control. Clinical inertia is present and the presence of more structured care in specialised diabetes centres, focusing on therapeutic guidelines, may explain the better overall metabolic control in patients followed up in shared care with these centres. J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart.New York.

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Year:  2009        PMID: 19358093     DOI: 10.1055/s-0028-1103286

Source DB:  PubMed          Journal:  Exp Clin Endocrinol Diabetes        ISSN: 0947-7349            Impact factor:   2.949


  14 in total

1.  Influence of chronic comorbidity and medication on the efficacy of treatment in patients with diabetes in general practice.

Authors:  Welcome Mkululi Wami; Frank Buntinx; Stefaan Bartholomeeusen; Geert Goderis; Chantal Mathieu; Marc Aerts
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2.  A successful chronic care program in Al Ain-United Arab Emirates.

Authors:  Latifa M Baynouna; Amal I Shamsan; Tahira A Ali; Lolowa A Al Mukini; Moza H Al Kuwiti; Thuraya A Al Ameri; Nico J D Nagelkerke; Ahmad M Abusamak; Nader M Ahmed; Sanaa M Zein Al Deen; Tariq M Jaber; Abdulkarim M Elkhalid; Anthony D Revel; Alhusini I Al Husaini; Fouad A Nour; Hayat O Ahmad; Mohammad K Nazirudeen; Rowaya Al Dhahiri; Yahya O Zain Al Abdeen; Aziza O Omar
Journal:  BMC Health Serv Res       Date:  2010-02-22       Impact factor: 2.655

3.  Effectiveness of the introduction of a Chronic Care Model-based program for type 2 diabetes in Belgium.

Authors:  Patricia Sunaert; Hilde Bastiaens; Frank Nobels; Luc Feyen; Geert Verbeke; Etienne Vermeire; Jan De Maeseneer; Sara Willems; An De Sutter
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4.  Does the Belgian diabetes type 2 care trajectory improve quality of care for diabetes patients?

Authors:  Viviane F A Van Casteren; Nathalie H E Bossuyt; Sarah J S Moreels; Geert Goderis; Katrien Vanthomme; Johan Wens; Etienne W De Clercq
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Review 5.  Factors associated with clinical inertia: an integrative review.

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7.  Interdisciplinary diabetes care teams operating on the interface between primary and specialty care are associated with improved outcomes of care: findings from the Leuven Diabetes Project.

Authors:  Liesbeth Borgermans; Geert Goderis; Carine Van Den Broeke; Geert Verbeke; An Carbonez; Anna Ivanova; Chantal Mathieu; Bert Aertgeerts; Jan Heyrman; Richard Grol
Journal:  BMC Health Serv Res       Date:  2009-10-07       Impact factor: 2.655

8.  Care for patients with type 2 diabetes in a random sample of community family practices in ontario, Canada.

Authors:  Gina Agarwal; Janusz Kaczorowski; Steve Hanna
Journal:  Int J Family Med       Date:  2012-07-18

9.  Nurse-led telecoaching of people with type 2 diabetes in primary care: rationale, design and baseline data of a randomized controlled trial.

Authors:  Irina Odnoletkova; Geert Goderis; Frank Nobels; Bert Aertgeerts; Lieven Annemans; Dirk Ramaekers
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10.  Poor glycemic control as a reason for referral of diabetes patients to specialists in Israel.

Authors:  Yacov Fogelman; Khaled Karkabi; Margalit Goldfracht
Journal:  J Community Hosp Intern Med Perspect       Date:  2016-04-25
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