Identifying targets to improve treatment in type 2 diabetes; the Groningen Initiative to aNalyse Type 2 diabetes Treatment (GIANTT) observational study
Article first published online: 4 AUG 2010
Copyright © 2010 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 19, Issue 10, pages 1078–1086, October 2010
How to Cite
Voorham, J., Haaijer-Ruskamp, F. M., van der Meer, K., de Zeeuw, D., Wolffenbuttel, B. H. R., Hoogenberg, K. and Denig, P. (2010), Identifying targets to improve treatment in type 2 diabetes; the Groningen Initiative to aNalyse Type 2 diabetes Treatment (GIANTT) observational study. Pharmacoepidem. Drug Safe., 19: 1078–1086. doi: 10.1002/pds.2023
- Issue published online: 4 AUG 2010
- Article first published online: 4 AUG 2010
- Manuscript Accepted: 22 JUN 2010
- Manuscript Revised: 28 MAY 2010
- Manuscript Received: 5 MAR 2010
Assessment of quality of cardiometabolic risk management in diabetes in primary care.
In a descriptive cohort study including 95 Dutch general practices, we assessed medication treatment in relation to the level of control for HbA1c, systolic blood pressure (SBP) and LDL-cholesterol (LDL-c) in 2007. We also applied a prospective measure of treatment quality by assessing treatment modifications in not well-controlled patients. In a subpopulation of 23 practices, we studied trends in these quality indicators from 2004 (2059 patients) to 2007 (2929 patients).
In 2007, averages for HbA1c, SBP and LDL-c were 6.9%, 142 mmHg and 2.3 mmol/l, respectively. Of the patients with an HbA1c > 8.5%, 16% were treated with one oral drug class and 50% used insulin. In 27% of these patients, therapy modification occurred subsequently. During the 4-year period, a slight decrease in average HbA1c was observed, but no changes in treatment level. In 2007, 56% of the patients had an SBP ≥140 mmHg, 19% of whom were not using antihypertensives. In the 13% with an SBP >160 mmHg, 23% received a therapy modification. During the 4-year period, the average SBP decreased with 6 mmHg but the treatment level showed no substantial increase. In 2007, 39% had an LDL-c level ≥2.5 mmol/l, 49% of whom were not using statins. Of the patients with an LDL-c >3.5 mmol/l, only 9% received a therapy modification.
The decreasing population averages of HbA1c, SBP and LDL-c values suggest improvement in quality of care. However, the relatively few therapy modifications observed in insufficiently controlled patients show room for improvement. Copyright © 2010 John Wiley & Sons, Ltd.