A better level of HbA1c control achieved by family medicine teams, Bosnia and Herzegovina, by using diabetes mellitus type 2 recommended guidelines.

AIM: To evaluate HbA1c level for diabetic type 2 patients after the implementation of guidelines for diabetes mellitus (GDM) in primary health care settings. According to recommendations of the European Society of Cardiology and European Association for the Study of Diabetes, HbA1c ≤ 6.5 % is considered as optimal level.
METHODS: A retrospective analysis randomly selected medical records of DM type 2 patients who were older than 18 before and after the review. Nineteen Family Medicine Teams (FMT) reviewed every second record (46 per FMT) in the family medicine facilities in Zenica two years prior and after the introduction of the Diabetes Mellitus 2 Guidelines. All noted values of HbA1c and all FMTs have been divided to those which reached an optimal level of HbA1c ≤ 6.5 % and those with an inadequate level (non-optimal level of HbA1c p< 6.5 %).
RESULTS: Records of 853 patients with type 2 diabetes were analyzed. A total number of HbA1c recorded in the FMT medical records increased significantly after the GDM implementation from 103 (12.1%) to 318 (37.3%). A significant improvement towards an optimal level of HbA1c was noted after the implementation GDM by all FMTs together (7 vs. 92; 6.7% vs. 28.9%; p<0.0001). Only FMT 4 and FMT 14 (2 vs.19; P < 0.05) reached the optimal level of HbA1c.
CONCLUSIONS: Family medicine teams improved the level of HbA1c according to the recommended guidelines for diabetes mellitus after their application. Quality variations of care extended to diabetics have been noted in individual family medicine teams.