Endocrine Abstracts

Background: Guidelines for management of diabetes mellitus (DM) provide standardization of care and treatment. National clinical practice guidelines on DM have been developed in 2006 by The Society of Endocrinology and Metabolism of Turkey and reviewed annually.

Methods: One hundred and eighty physicians evaluated previous 12 months’ medical records of their type 2 DM patients with special emphasis on whether the patients were followed consistently with national guidelines. This report depends on the analysis of 6032 visits of 1790 patients. Adherence to guidelines was scored to reach a total adherence score of 0–10 for three dimensions of adherence (taking medical history (HISTORY), physical examination (PHY_EXAM) and laboratory evaluation (LAB_EVAL)). Total adherence score was calculated by multiplying the mean of HISTORY, PHY_EXAM and LAB_EVAL scores by 10 (range: 0–100).

Results: Mean age was 58.7±10.9 years and 62% were women. The mean duration of DM was 7.7±7.5 years. Total adherence score didn’t show any relationship with gender and age, but LAB_EVAL score was better in male patients (6.84 vs 6.53 out of 10; P=0.021) and differed between age groups (40–49 years was the group with the lowest general adherence score). All of the adherence dimensions were related with duration of DM; for 0–5 years of DM, total adherence score and HISTORY, PHY_EXAM and LAB_EVAL scores were significantly lower than groups with longer duration of DM (all P<0.05). PHY_EXAM, LAB_EVAL and total adherence scores were better in patients with chronic complications (all P<0.05). PHY_EXAM and LAB_EVAL scores were significantly higher in university hospitals versus state hospitals (P<0.05). With the mean score of 84.5, total adherence of endocrinologists was significantly better than of both family physicians and internists (P<0.005).

Comment: We suggest that in order to overcome barriers to increase the adherence to guidelines, factors related with patients and physicians should be studied and understood well.