Endocrine Abstracts

The current PDA recommendations relating to the good metabolic control of diabetes are: self-controlled fasting blood glucose (FBG)70–90 mg%, HbA1c ≤6.1%, lipid profile (LP) TChol ≤175 mg%, LDL≤100 mg%, HDL ≥40 mg%, TG≤150 mg%.

Objective: To evaluate the accomplishment of the proper metabolic control in diabetic outpatients with regard to the PDA guidelines.

Material and Methods: a548 diabetics (249M; 299F), aged 18–83 years (mean 56.2±14,9), treated between 2004 – 2005 have been studied. The patients were classified into 3 groups: with type 1 (16.1%), type 2 (79%) and type 3 diabetes (4.9%). In metabolic control were assessed: self-controlled FBG, HbA1c, and LP. The patients have been evaluated according to HbA1c and the number of the reached parameters.

Results: Mean levels for whole group and subgroups with type 1, 2 and 3 diabetes were: for FBG 127.4±35.3; 134.8±47.0; 125.8±30.9; 124.8±40.5 mg%; for TChol: 203.1±43.3; 194.6±39.5; 207.2±44.4; 175.9±36.0 mg% and HbA1c 7.35±1.5%; 7.7±1.6%; 7.2±1.4%; and 8.21±1.9% respectively.

Comments: The mean values of estimated parameters in all groups of diabetic patients were more higher than those recommended by PDA. In 25% of all cases, HbA1c level was ≤ 6.1% and moreover in nearly half of them it was ‘satisfactory’ below 7%. Simultaneously, only 3% of the patients reached 3 criteria of good metabolic control, whereas over 50% achieved none criterion.

Conclusions: In the most of diabetic outpatients, the degree of the metabolic control remain unsatisfactory. In practice, it seems to be difficult to achieve the all criteria recommended by PDA. As for the outcomes considered more attention should be paid to the patient educational programs, life-style counseling, practice guidelines as well as more effective diabetes management overcoming the ‘ clinical inertia’.