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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 BMJ+Open+Diabetes+Res+Care
2017 ; 5
(1
): e000459
Nephropedia Template TP
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Type 2 diabetes in general practice in Norway 2005-2014: moderate improvements in
risk factor control but still major gaps in complication screening
#MMPMID29177051
Bakke Å
; Cooper JG
; Thue G
; Skeie S
; Carlsen S
; Dalen I
; Løvaas KF
; Madsen TV
; Oord ER
; Berg TJ
; Claudi T
; Tran AT
; Gjelsvik B
; Jenum AK
; Sandberg S
BMJ Open Diabetes Res Care
2017[]; 5
(1
): e000459
PMID29177051
show ga
OBJECTIVE: To assess the status of type 2 diabetes care in general practice and
changes in the quality of care between 2005 and 2014, and to identify areas of
diabetes care requiring improvement. RESEARCH DESIGN AND METHODS: Two
cross-sectional surveys were performed that included patients with type 2
diabetes in selected areas (n=9464 in 2014, n=5463 in 2005). Quality of care was
assessed based on key recommendations in national guidelines. Differences in
clinical performance between 2005 and 2014 were assessed in regression models
adjusting for age, sex, counties and clustering within general practices.
RESULTS: Treatment targets were achieved in a higher proportion of patients in
2014 compared with 2005: hemoglobin A1c ?7.0% (?53?mmol/mol) in 62.8% vs 54.3%,
blood pressure ?135/80?mm Hg in 44.9% vs 36.6%, and total cholesterol ?4.5?mmol/L
in 49.9% vs 33.5% (all adjusted P?0.001). Regarding screening procedures for
microvascular complications, fewer patients had recorded an eye examination
(61.0% vs 71.5%, adjusted P<0.001), whereas more patients underwent monofilament
test (25.9% vs 18.7%, adjusted P<0.001). Testing for albuminuria remained low
(30.3%) in 2014. A still high percentage were current smokers (22.7%).
CONCLUSIONS: We found moderate improvements in risk factor control for patients
with type 2 diabetes in general practice during the last decade, which are
similar to improvements reported in other countries. We report major gaps in the
performance of recommended screening procedures to detect microvascular
complications. The proportion of daily smokers remains high. We suggest
incentives to promote further improvements in diabetes care in Norway.