Changes over time in the prevalence and quality of care of type 2 diabetes in Italy: The Casale Monferrato Surveys, 1988 and 2000

Background and aims: In this study we assessed the prevalence of diagnosed type 2 diabetes and the quality of care during the period 1988-2000 in an Italian population. Methods and results: Two population-based surveys, using similar methods and centralized measurements, were conducted in 1988 and 2000 in a representative Italian area to identify people with known diabetes. The adjusted prevalence (reference, 2001 Italian population) was computed. The age- and sex-adjusted prevalence rates of diabetes in the population of Casale Monferrato were 2.13% (2.05-2.22) in 1988 and 3.07% (2.97-3.17) in 2000. In comparison with diabetic persons recruited in 1988 and independently of age and sex, persons recruited in 2000 had a lower likelihood of having HbA1c >= 7.0% (OR = 0.48; 0.42-0.56), diastolic blood pressure >= 80 mmHg (OR = 0.61; 0.49-0.75), LDL cholesterol >= 2.59 mmol/l (OR = 0.77; 0.63-0.93) and AER >= 20 mu g/min (OR = 0.53; 0.45-0.61; they had a higher likelihood of having BMI >= 25 kg/m(2) (OR = 1.49; 1.2-1.74). However, 45.4% of patients still had HbA1c >= 7.0%, 80% blood pressure >= 130/80 mmHg and 79% LDL-cholesterol values >= 2.59 mmol/l. Conclusion: More than two-thirds of Italians with diabetes are now aged 65 years and more. The quality of control of glycemia, lipids and blood pressure improved and the prevalence of diabetic nephropathy decreased over time, although complete adherence to international guidelines has not yet been achieved. (c) 2006 Elsevier B.V. All rights reserved.