Outpatient Diabetic Care in a Public Central Hospital: Patient Characteristics, Therapeutic Regimens and Results

Joao Martin Martins, Sonia do Vale, Ana Filipa Martins, Ana Raquel Gomes, Lagoa Vicente, Jorge Caldeira

Abstract


Background: Report of patient characteristics, treatment and results of diabetic patients assisted at a public tertiary hospital.

Patients and Methods: Standardized clinical and analytical data regarding patients assisted during 2 years.

Results: Nine hundred and seventy-one visits and 271 patients were studied. Patients with type 1 (DM1) (15%), type 2 treated with insulin (DM2-IT) (23%) and type 2 treated with oral agents (DM2-NIT) (56%) were included. On referral, long-standing disease (11 ± 9 years) was present with poor metabolic control (glycated hemoglobin, HbA1c 8.4 ± 2.0%). Microvascular disease (33-40%), high blood pressure (HBP) (56%) and dyslipidemia (61%) were common. Intensive treatment was used in less than half of the patients. Most of DM2 patients were under medication for HBP and were using anti-platelet agents (76%) but less than half (46%) were using lipid-lowering drugs. Despite frequent medical visits, metabolic control remained poor, HbA1c 8.0 ± 1.9%. In almost half of DM2 patients, systolic blood pressure (45%), serum cholesterol (36%), serum triglycerides (42%) and HDLc (37%) remain higher or lower than recommended.

Conclusions: Two fundamental vectors seem to underlie the clinical evolution: aging and beta-cell function. DM2-IT represents a group of specially difficult patients. Intensive medical assistance of diabetic patients is still far from routine even in tertiary hospitals.




J Endocrinol Metab. 2014;4(1-2):13-24
doi: http://dx.doi.org/10.14740/jem205w

Keywords


Diabetic patients; Metabolic control; Blood pressure; Dyslipidemia

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