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Compliance with guidelines for disease management in diabetes: results from the SwissDiab Registry
  1. Katrin E Schimke1,
  2. Frida Renström1,
  3. Sandro Meier1,
  4. Christoph Stettler2,
  5. Michael Brändle1
  6. the SwissDiab Study Group
  1. 1 Division of Endocrinology and Diabetes, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
  2. 2 Division of Endocrinology, Diabetes and Clinical Nutrition, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
  1. Correspondence to Prof. Michael Brändle, Division of Endocrinology and Diabetes, Cantonal Hospital St. Gallen, St. Gallen 9007, Switzerland; Michael.Braendle{at}kssg.ch

Abstract

Objective Tight glycemic control and aggressive treatment of additional cardiovascular risk factors can substantially reduce risk of diabetes-related complications. In 2013, the Swiss Society of Endocrinology and Diabetology (SSED) established national criteria on good disease management in diabetes, but little is known about compliance in clinical care. Here we assessed to what extent patients from two tertiary care centers in the German-speaking part of Switzerland enrolled in the Swiss Diabetes (SwissDiab) Registry adhere to the SSED criteria.

Research design and methods SwissDiab is a prospective observational cohort study of patients regularly treated at Swiss tertiary diabetes centers. Data were collected through standardized annual health examinations. Baseline participant descriptive statistics, stratified by diabetes mellitus type 1 (DM1) and type 2 (DM2), were compared with SSED targets for glycemic control, blood pressure, blood lipids, weight maintenance, and ophthalmic examination.

Results By the end of 2016, 604 participants with DM1 (40%) and DM2 (60%) had data available for analyses, 36% and 29% women, respectively. At baseline, all the SSED targets were met with two exceptions: a glycated hemoglobin A1c value <7% was measured in 32% of participants with DM1 (SSED target: ≥40%) and 47% and 56% of overweight or obese participants with DM1 and DM2, respectively, received nutritional counseling in the previous year (SSED target: ≥80%).

Conclusions The SSED targets for good disease management in diabetes were achieved in the majority of participants at the time of enrollment, but results also highlight areas where disease management can be improved, particularly the role of nutrition counseling.

  • adult diabetes
  • type 1
  • type 2
  • management and care

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors MB conceptualized the research question, KES and MB led the study design, CS and MB provided data, FR and SM performed the statistical analysis, FR and KES interpreted the results and drafted the manuscript. All authors made critical revision of the article for key intellectual content and approved the final version of the manuscript.

  • Funding Funding for SwissDiab was received from the Swiss Diabetes Foundation, CTU Cantonal Hospital St.Gallen, unrestricted grants from pharmaceutical companies (alphabetical order): Astra Zeneca, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Novo Nordisk, Roche, Sanofi.

  • Disclaimer None of the funders had any active role in the design of the study, collection, analysis or interpretation of the data, or in the writing of the paper.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study protocol was approved by the cantonal ethics committees of St. Gallen and Bern (EKSG09/114/L) and conducted in accordance with the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data not publicly available

  • Collaborators Peter Diem, Markus Laimer, Andreas Melmer; Division of Endocrinology, Diabetes and Clinical Nutrition, Inselspital, University Hospital Bern; Switzerland. Roger Lehmann, Philipp Gerber, Jan Krützfeldt; Division of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Zurich, Switzerland

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