Evaluation of risk factors for development of complications in Type II diabetes in Europe

Aims/hypothesis. The Cost of Diabetes in Europe Type II study is the first large coordinated attempt to measure the current standard of care and determine the costs of managing patients with Type II (non-insulin-dependent) diabetes mellitus. Methods. The study evaluated glycaemic control, blood lipid levels and blood pressure, all of which are risk factors for complications. Records of these clinical characteristics were collected from over 7000 patients during the 6-month study period. Results. The mean HbA(1c) value for the entire study population was 7.5%, ranging from 7.0% in Sweden to 7.8% in the United Kingdom. Only 31% of individuals achieved good glycaemic control (HbA(1c) less than or equal to=6.5%) according to current European guidelines. Only 64% of the total study population were tested for HbA(1c) values at least once within the 6-month study period (ranging from 49% in Spain to 71% in the UK), although HbA(1c) testing every 3 months is recommended for all patients, by European Diabetes Policy Group guidelines. The majority of patients had borderline total cholesterol values, with a mean value of 5.7 mmol/l. Overall, 21% of patients were classified as having low risk cholesterol levels (<4.8 mmol/l). Good triglyceride levels (<1.7 mmol/l) were achieved by 47% of the total study population. During the study period, 81% of patients had their blood pressure measured, with 35% and 53.3% of the patients reaching the recommended targets for systolic and diastolic blood pressure, respectively. Conclusion/interpretation. This study showed that a high proportion of patients with risk factors for diabetes-related complications are not adequately controlled. Improvements in disease management and monitoring are therefore required to ensure that guideline targets are met, thus reducing the long-term complications of Type II diabetes.