An audit on diabetes management in Asian patients treated by specialists: the Diabcare-Asia 1998 and 2003 studies

ABSTRACT

Objective: To collect information on diabetes management, including psychosocial aspects, in patients managed by specialists 5 years after they were first surveyed in 1998.

Methods: Data on demography, diabetes status, management and complications were collected via medical records, interview and laboratory assessments. HbA_1c was analysed by a central laboratory prospectively.

Results: Patient profile was similar in the 1998 (N = 21 838) and 2003 cohorts (N = 15 549): 95% were diagnosed as type 2 diabetes mellitus and were obese (BMI ≈ 25 kg/m²). Glycaemic control was unsatisfactory in many patients (mean HbA_1c ≈ 8%; fasting glucose ≈ 9 mmol/L). Lipids were well-controlled but hypertension was not. The incidence of neuropathy (≈ 33%) and cataract (≈ 27%) were high. The majority (≈ 71%) of patients in both cohorts were treated with oral antidiabetic drug (OAD) monotherapy; ≈ 24% were on insulin therapy. Approximately half of the 2003 cohort reported a healthy state of well-being. Quality of life did not appear to have suffered as a result of having diabetes. However, many patients were worried about hypoglycaemic risk (53.9%) or worsening of diabetes (45.8%) and insulin initiation (64.5%).

Conclusions: Although both cohorts were separate cross-sectional studies of diabetes management status in Asia, the results showed that the demography profile, glycaemic control and cardiovascular risk factors were remarkably similar in both cohorts 5 years after the first survey. More concerted efforts are needed to increase diabetes awareness and education.