Skip to main content
Top
Published in: Diabetes Therapy 2/2019

Open Access 01-04-2019 | Care | Brief Report

Improvement in Quality of Care for Patients with Type 2 Diabetes in Hungary Between 2008 and 2016: Results from Two Population-Based Representative Surveys

Authors: Attila Nagy, Nóra Kovács, Anita Pálinkás, Valéria Sipos, Ferenc Vincze, Gergő Szőllősi, Róza Ádány, Árpád Czifra, János Sándor

Published in: Diabetes Therapy | Issue 2/2019

Login to get access

Abstract

Introduction

Due to the increasing trends of recent decades, diabetes prevalence has reached a frequency of 1/11 adults worldwide. However, this disadvantageous trend has not been accompanied by worsened outcome indicators; better short-term (e.g., HbA1c levels) and long-term [e.g., all-cause mortality among type 2 diabetes mellitus (T2DM) patients] outcomes can be observed globally. We aimed to describe changes in the effectiveness of type 2 diabetes mellitus care between 2008 and 2016 based on outcome indicators.

Methods

The study is a secondary analysis of data from two previously performed surveys. Both surveys were conducted in the framework of the General Practitioners’ Morbidity Sentinel Stations Program (GPMSSP), which maintains a nationally representative registry of T2DM patients.

Results

The largest improvement was observed in achieving fasting blood glucose and HbA1c target values [OR = 0.67, 95% confidence interval (CI), 0.56–0.80 and OR = 0.58; 95% CI, 0.48–0.70, respectively]. Moderate improvement was detected by reaching body mass index (BMI), diastolic blood pressure and total cholesterol target values (OR = 0.78, 95% CI, 0.65–0.93; OR = 0.78, 95% CI, 0.65–0.94 and OR = 0.76, 95% CI, 0.63–0.92, respectively).

Conclusion

Our study demonstrated that if standardized indicators are investigated in population-based samples, the effectiveness of T2DM care can be monitored by ad hoc surveys. The systematic application of this approach completed with the detailed documentation of the applied therapies could demonstrate the public health impact of certain modifications in T2DM care. An overall improvement in metabolic control (glycaemic control, lipid status and obesity) was observed, which was not accompanied by improved therapeutic target achievement for systolic blood pressure.
Literature
2.
go back to reference Abd El, Aziz MS, Kahle M, Meier JJ, Nauck MA. A meta-analysis comparing clinical effects of short- or long-acting GLP-1 receptor agonists versus insulin treatment from head-to-head studies in type 2 diabetic patients. Diabetes Obes Metab. 2017;19:216–27. Abd El, Aziz MS, Kahle M, Meier JJ, Nauck MA. A meta-analysis comparing clinical effects of short- or long-acting GLP-1 receptor agonists versus insulin treatment from head-to-head studies in type 2 diabetic patients. Diabetes Obes Metab. 2017;19:216–27.
3.
go back to reference Herrero Gil AM, Pinillos Robles J, Sabio Repiso P, Martín Maldonado JL, Garzón González G. Gil de Miguel Á [Trends in the level of control of patients with type 2 diabetes from 2010 to 2015]. Aten Primaria. 2018;50:459–66.PubMedCrossRef Herrero Gil AM, Pinillos Robles J, Sabio Repiso P, Martín Maldonado JL, Garzón González G. Gil de Miguel Á [Trends in the level of control of patients with type 2 diabetes from 2010 to 2015]. Aten Primaria. 2018;50:459–66.PubMedCrossRef
4.
go back to reference Luo M, Tan KHX, Tan CS, Lim WY, Tai E-S, Venkataraman K. Longitudinal trends in HbA1c patterns and association with outcomes: a systematic review. Diabetes Metab Res Rev. 2018;34:e3015.PubMedPubMedCentralCrossRef Luo M, Tan KHX, Tan CS, Lim WY, Tai E-S, Venkataraman K. Longitudinal trends in HbA1c patterns and association with outcomes: a systematic review. Diabetes Metab Res Rev. 2018;34:e3015.PubMedPubMedCentralCrossRef
5.
go back to reference Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and trends in diabetes among adults in the United States, 1988–2012. JAMA. 2015;314:1021–9.PubMedCrossRef Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and trends in diabetes among adults in the United States, 1988–2012. JAMA. 2015;314:1021–9.PubMedCrossRef
6.
go back to reference Yang Y, Chen S, Pan H, Zou Y, Wang B, Wang G, et al. Safety and efficiency of SGLT2 inhibitor combining with insulin in subjects with diabetes: systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2017;96:e6944.PubMedPubMedCentralCrossRef Yang Y, Chen S, Pan H, Zou Y, Wang B, Wang G, et al. Safety and efficiency of SGLT2 inhibitor combining with insulin in subjects with diabetes: systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2017;96:e6944.PubMedPubMedCentralCrossRef
12.
go back to reference Jermendy G, Kiss Z, Rokszin G, Abonyi-Tóth Z, Wittmann I. Kempler P [Trends in antidiabetic treatment prescribed for patients with type 2 diabetes in Hungary between 2001 and 2014—results from the database analysis of the National Health Insurance Fund]. Orv Hetil. 2017;158:770–8.PubMedCrossRef Jermendy G, Kiss Z, Rokszin G, Abonyi-Tóth Z, Wittmann I. Kempler P [Trends in antidiabetic treatment prescribed for patients with type 2 diabetes in Hungary between 2001 and 2014—results from the database analysis of the National Health Insurance Fund]. Orv Hetil. 2017;158:770–8.PubMedCrossRef
13.
go back to reference Jermendy G, Kiss Z, Rokszin G, Abonyi-Tóth Z, Wittmann I, Kempler P. Persistence to treatment with novel antidiabetic Drugs (dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter-2 inhibitors, and glucagon-like peptide-1 receptor agonists) in people with type 2 diabetes: a nationwide cohort study. Diabetes Ther Res Treat Educ Diabetes Relat Disord. 2018;9:2133–41. Jermendy G, Kiss Z, Rokszin G, Abonyi-Tóth Z, Wittmann I, Kempler P. Persistence to treatment with novel antidiabetic Drugs (dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter-2 inhibitors, and glucagon-like peptide-1 receptor agonists) in people with type 2 diabetes: a nationwide cohort study. Diabetes Ther Res Treat Educ Diabetes Relat Disord. 2018;9:2133–41.
14.
go back to reference Roman G, Hancu N. Early insulin treatment to prevent cardiovascular disease in prediabetes and overt diabetes. Horm Metab Res Horm Stoffwechselforschung Horm Metab. 2009;41:116–22.CrossRef Roman G, Hancu N. Early insulin treatment to prevent cardiovascular disease in prediabetes and overt diabetes. Horm Metab Res Horm Stoffwechselforschung Horm Metab. 2009;41:116–22.CrossRef
17.
go back to reference de Pablos-Velasco P, Parhofer KG, Bradley C, Eschwège E, Gönder-Frederick L, Maheux P, et al. Current level of glycaemic control and its associated factors in patients with type 2 diabetes across Europe: data from the PANORAMA study. Clin Endocrinol (Oxf). 2014;80:47–56.CrossRef de Pablos-Velasco P, Parhofer KG, Bradley C, Eschwège E, Gönder-Frederick L, Maheux P, et al. Current level of glycaemic control and its associated factors in patients with type 2 diabetes across Europe: data from the PANORAMA study. Clin Endocrinol (Oxf). 2014;80:47–56.CrossRef
18.
go back to reference Stone MA, Charpentier G, Doggen K, Kuss O, Lindblad U, Kellner C, et al. Quality of care of people with type 2 diabetes in eight European countries: findings from the Guideline Adherence to Enhance Care (GUIDANCE) study. Diabetes Care. 2013;36:2628–38.PubMedPubMedCentralCrossRef Stone MA, Charpentier G, Doggen K, Kuss O, Lindblad U, Kellner C, et al. Quality of care of people with type 2 diabetes in eight European countries: findings from the Guideline Adherence to Enhance Care (GUIDANCE) study. Diabetes Care. 2013;36:2628–38.PubMedPubMedCentralCrossRef
19.
go back to reference Széles G, Vokó Z, Jenei T, Kardos L, Pocsai Z, Bajtay A, et al. A preliminary evaluation of a health monitoring programme in Hungary. Eur J Public Health. 2005;15:26–32.PubMedCrossRef Széles G, Vokó Z, Jenei T, Kardos L, Pocsai Z, Bajtay A, et al. A preliminary evaluation of a health monitoring programme in Hungary. Eur J Public Health. 2005;15:26–32.PubMedCrossRef
20.
go back to reference Nagy A, Adany R, Sandor J. Effect of diagnosis-time and initial treatment on the onset of type 2 diabetes mellitus complications: a population-based representative cross-sectional study in Hungary. Diabetes Res Clin Pract. 2011;94:e65–7.PubMedCrossRef Nagy A, Adany R, Sandor J. Effect of diagnosis-time and initial treatment on the onset of type 2 diabetes mellitus complications: a population-based representative cross-sectional study in Hungary. Diabetes Res Clin Pract. 2011;94:e65–7.PubMedCrossRef
21.
go back to reference Nagy A, Nagy B, Adany R, Sandor J. Determinants of low referral rates for ophthalmologic examination in people with type 2 diabetes in Hungary. Diabetes Res Clin Pract. 2013;102:e29–31.PubMedCrossRef Nagy A, Nagy B, Adany R, Sandor J. Determinants of low referral rates for ophthalmologic examination in people with type 2 diabetes in Hungary. Diabetes Res Clin Pract. 2013;102:e29–31.PubMedCrossRef
22.
go back to reference Nagy A, Kovács N, Pálinkás A, Sipos V, Vincze F, Szőllősi G, et al. Exploring quality of care and social inequalities related to type 2 diabetes in Hungary: nationwide representative survey. Prim Care Diabetes. 2018;12:199–211.PubMedCrossRef Nagy A, Kovács N, Pálinkás A, Sipos V, Vincze F, Szőllősi G, et al. Exploring quality of care and social inequalities related to type 2 diabetes in Hungary: nationwide representative survey. Prim Care Diabetes. 2018;12:199–211.PubMedCrossRef
23.
go back to reference Sándor J, Nagy A, Jenei T, Földvári A, Szabó E, Csenteri O, et al. Influence of patient characteristics on preventive service delivery and general practitioners’ preventive performance indicators: a study in patients with hypertension or diabetes mellitus from Hungary. Eur J Gen Pract. 2018;24:183–91.PubMedPubMedCentralCrossRef Sándor J, Nagy A, Jenei T, Földvári A, Szabó E, Csenteri O, et al. Influence of patient characteristics on preventive service delivery and general practitioners’ preventive performance indicators: a study in patients with hypertension or diabetes mellitus from Hungary. Eur J Gen Pract. 2018;24:183–91.PubMedPubMedCentralCrossRef
24.
go back to reference Sándor J, Nagy A, Földvári A, Szabó E, Csenteri O, Vincze F, et al. Delivery of cardio-metabolic preventive services to Hungarian Roma of different socio-economic strata. Fam Pract. 2017;34:83–9.PubMedCrossRef Sándor J, Nagy A, Földvári A, Szabó E, Csenteri O, Vincze F, et al. Delivery of cardio-metabolic preventive services to Hungarian Roma of different socio-economic strata. Fam Pract. 2017;34:83–9.PubMedCrossRef
25.
go back to reference Cunningham SG, Carinci F, Brillante M, Leese GP, McAlpine RR, Azzopardi J, et al. Core Standards of the EUBIROD Project. Defining a European Diabetes Data Dictionary for Clinical Audit and Healthcare Delivery. Methods Inf Med. 2016;55:166–76.PubMedCrossRef Cunningham SG, Carinci F, Brillante M, Leese GP, McAlpine RR, Azzopardi J, et al. Core Standards of the EUBIROD Project. Defining a European Diabetes Data Dictionary for Clinical Audit and Healthcare Delivery. Methods Inf Med. 2016;55:166–76.PubMedCrossRef
Metadata
Title
Improvement in Quality of Care for Patients with Type 2 Diabetes in Hungary Between 2008 and 2016: Results from Two Population-Based Representative Surveys
Authors
Attila Nagy
Nóra Kovács
Anita Pálinkás
Valéria Sipos
Ferenc Vincze
Gergő Szőllősi
Róza Ádány
Árpád Czifra
János Sándor
Publication date
01-04-2019
Publisher
Springer Healthcare
Published in
Diabetes Therapy / Issue 2/2019
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI
https://doi.org/10.1007/s13300-019-0582-x

Other articles of this Issue 2/2019

Diabetes Therapy 2/2019 Go to the issue