Endocrine Abstracts

Introduction: Diabetes mellitus (DM) is a chronic disease that can be largely managed in the primary care system.

Aim: We analysed medical records of diabetic patients (pts) treated in Center for diabetes in our institution, during 1 year, determining the quality of care.

Material and methods: The search was focused on pts at first admission to the diabetologist. Analysis included demographic and clinical characteristics of pts, metabolic control, prevalence of diabetic complications and cardiovascular risk factors. All data related to every patient were found searching the central medical database. The analysis covered the last 3 years, with all available laboratory results, hospitalizations and specialist exams.

Results: Between 4,792 medical records, 236 patients were examined for the first time in outpatient clinic, and 156 pts during hospitalization. Of 236 ambulatory pts, 100 were newly diagnosed (1), and 136 were known DM pts (2). In the first subgroup (1) HbA1c measurements were found in 39% of pts, renal parameters in 69%, hepatal function was determined in 72% of pts, microalbuminuria in 3% and fundoscopy in 13% of pts. Thirty one percent of pts were later diagnosed. In the second subgroup (2) HbA1c was measured in 69% of pts, renal parameters in 85%, hepatal function was determined in 77% of pts, microalbuminuria in 7% and fundoscopy in 13% of pts; 7% of pts were diagnosed later. Only 12% of pts in subgroup (1) had an initial therapy prescribed in primary health care.

Conclusions: The quality of primary care of diabetic patients requires improvement. Evaluation of chronic complication, laboratory exams, timely diagnosis of DM, initiation of the therapy should be more frequent and regular, following the existing guidelines of care of DM patients.