Endocrine Abstracts

Aims: To evaluate stepped care intervention for patients with type 2 diabetes.

Method: The audit dealt with 191 patients with type 2 diabetes who were treated at a general hospital in Norway between 2007 and 2012. A local database looked after process and results.

Results: The intervention increased the number of antihypertensive drugs, and the dose of metformin and insulin. That lowered mean levels of systolic blood pressure from 142 to 132 mmHg, LDL cholesterol from 2.6 to 2.1 mmol/l, and, HbA1c from 8.5 to 7.6% (64–57 mmol/mol, P< 0.001, t-tests). In multiple linear regression analyses, decrease of the three metabolic risk factors was significantly associated with first level of the risk factors and the number of visits or follow-up. One patient had severe hypoglycaemia but else toxicity was moderate. Ten patients died.

Conclusions: Local computerized surveillance of the intervention helped to improve the complex treatment for poorly controlled type 2 diabetes. The improvement continued over four years of follow-up.