Wens J, Van Casteren V, Vermeire E, Van Royen P, Pas L, Denekens J
Centre for Family Medicine, University of Antwerp, Antwerpen, Belgium.
Eur J Epidemiol. 2001;17(8):743-50. doi: 10.1023/a:1015627912556.
The objective of this descriptive study is to investigate the incidence of type 2 diabetes in sentinel general practices in three regions in Belgium and to describe the patient characteristics and the start of the medical management after diagnosis.
For two successive years all patients who were newly diagnosed with type 2 diabetes were registered. Two weeks after inclusion, the registering physician completed an extensive questionnaire. This questionnaire dealt with risk factors, biochemical parameters, existing complications and treatment.
According to this study, the yearly incidence of type 2 diabetes in Belgium is 231 per 100,000 inhabitants. Though the biochemical parameters (BMI, HbA1c, serum cholesterol and triglycerides) do not differ in the three regions of the country being investigated, there are considerable differences in the treatment prescribed for diabetes and its co-morbidity. In Flanders, treatment is usually started with sulphonylurea, in the Walloon provinces with biguanides. Hypolipaemic treatment is also started more frequently in the latter region. In Flanders, hypertension is registered in 51.4% of the newly diagnosed patients with diabetes, which is higher than in the other regions. However, no difference is noted between the different regions in the number of patients with diabetes who are treated for hypertension.
A network of sentinel physicians, taking part in voluntary registration, can be helpful in calculating the incidence of a health problem, in particular type 2 diabetes in general practice. The sentinel net can also serve as an instrument for describing patient characteristics and showing how physicians deal with health problems. The regional differences in medical approach that are described require further investigation, mainly with respect to their impact on the patients' outcome.
这项描述性研究的目的是调查比利时三个地区哨点全科医疗中2型糖尿病的发病率，并描述患者特征以及诊断后的医疗管理起始情况。
连续两年对所有新诊断为2型糖尿病的患者进行登记。纳入两周后，登记医生填写一份详尽的问卷。该问卷涉及危险因素、生化参数、现存并发症及治疗情况。
根据本研究，比利时2型糖尿病的年发病率为每10万居民231例。尽管在被调查国家的三个地区生化参数（体重指数、糖化血红蛋白、血清胆固醇和甘油三酯）并无差异，但在糖尿病及其合并症的处方治疗方面存在显著差异。在弗拉芒地区，治疗通常从使用磺脲类药物开始，而在瓦隆省则从使用双胍类药物开始。后者地区也更频繁地开始使用降血脂治疗。在弗拉芒地区，51.4%新诊断的糖尿病患者登记患有高血压，这一比例高于其他地区。然而，不同地区接受高血压治疗的糖尿病患者数量并无差异。
参与自愿登记的哨点医生网络有助于计算健康问题的发病率，尤其是全科医疗中的2型糖尿病发病率。哨点网络还可作为描述患者特征以及展示医生如何处理健康问题的工具。所描述的医疗方法的地区差异需要进一步调查，主要是关于它们对患者预后的影响。
