Gudlaugsdottir Hafdis Lilja, Sigurdardottir Arun Kristin
Sudurnes Hospital and Health Center, Iceland, Landspitali University Hospital.
School of Health Sciences, University of Akureyri, Iceland, 4Akureyri Hospital Iceland.
Laeknabladid. 2018 Apr;104(4):171-176. doi: 10.17992/lbl.2018.04.180.
Diabetes is a chronic disease often with serious and costly complications. Therefore well organised diabetes care is needed. The purpose was to research outcome of treatment on biological parameters in people with type one and two diabetes in one primary care over ten years and compare with international guidelines.
Retrospective cohort study, information was gathered from medical records at Sudurnes Health Center, in the years 2005, 2010 and 2015. The sample was persons listed in diabetes unit in beginning of 2005. One measurement for every participant each of the three years was used (n=113). Biological parameters were analysed and compared to international guidelines and attendance to clinic examined.
HbA1c level was 7.22% in 2005 but increased significantly to 7.56% in 2015. Diastolic blood pressure decreased significantly to 2015. Most achieved international guidelines in HbA1c goals in 2005 (51%), HDL in 2010 (43.8%), LDL in 2015 (41.9%) TG, in 2010 (79.8%), BMI in 2015 (44.2%), systolic blood pressure in 2010 (63.4%) and diastolic blood pressure in 2015 (74.2%). BMI was around 32 kg/m² in all three years. In 2015, association was found between neuropathic symptoms and higher HbA1c level. Documentation regarding diabetes complications became much better in 2015 when a new form for electronic documentation was launched.
Tighter blood glucose control is needed to lessen risk of complications, as well as to reduce lipid and bloodpressure leves closer to international guidelines. Improving documentation is important.
糖尿病是一种慢性病，常常伴有严重且代价高昂的并发症。因此，需要组织完善的糖尿病护理。目的是研究在一家初级保健机构中，一型和二型糖尿病患者十年间治疗对生物学参数的影响，并与国际指南进行比较。
回顾性队列研究，收集了2005年、2010年和2015年于南苏讷斯健康中心的医疗记录信息。样本为2005年初在糖尿病科室登记的人员。对每位参与者在这三年中各进行一次测量（n = 113）。分析生物学参数并与国际指南进行比较，同时检查门诊就诊情况。
2005年糖化血红蛋白（HbA1c）水平为7.22%，但在2015年显著升至7.56%。舒张压在2015年显著下降。2005年大多数患者达到了HbA1c目标的国际指南要求（51%），2010年达到高密度脂蛋白（HDL）目标的比例为43.8%，2015年达到低密度脂蛋白（LDL）目标的比例为41.9%，2010年达到甘油三酯（TG）目标的比例为79.8%，2015年达到体重指数（BMI）目标的比例为44.2%，2010年达到收缩压目标的比例为63.4%，2015年达到舒张压目标的比例为74.2%。三年中BMI均约为32kg/m²。2015年，发现神经病变症状与较高的HbA1c水平之间存在关联。2015年推出新的电子文档表格后，关于糖尿病并发症的记录有了很大改善。
需要更严格地控制血糖以降低并发症风险，同时将血脂和血压水平更接近国际指南。改善记录很重要。
