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Glycaemic control and lipid concentrations in a cohort of people with diabetes over 7 years of follow‐up: a regional audit of diabetes care in the UK
Author(s) -
Wainwright P.,
Oluwatowoju I.,
Ryan A.,
Abu E.,
Byrne C. D.
Publication year - 2016
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12853
Subject(s) - medicine , diabetes mellitus , odds ratio , cholesterol , cohort , logistic regression , triglyceride , confidence interval , endocrinology
Aim To determine changes in glycaemic control and lipids over time since the introduction of the Quality and Outcomes Framework. Methods In adults with diabetes (Hampshire, UK ), HbA 1c and lipid measurements were retrieved from a regional National Health Service biochemical database in 2006 and 2013 and analysed using anova and logistic regression modelling. Results In 2006, 8568 people with diabetes were identified. In 2013, 5815 had follow‐up data, 1207 people were lost to follow‐up and 1546 had died. At baseline, HbA 1c concentrations were 62.1 ± 16.1, 64.7 ± 16.7 and 64.5 ± 17.6 mmol/mol for those with follow‐up data, those lost to follow‐up and those who died, respectively. The mean age was 60.2 ± 14.5, 57.6 ± 18.0 and 73.9 ± 10.5 years, respectively, for the three groups. Total cholesterol, HDL cholesterol and triglyceride concentrations were similar between groups. The mean HbA 1c concentration for those with complete follow‐up data was 62.1 ± 16.1 mmol/mol in 2006 and 61.7 ± 17.3 mmol/mol in 2013. Quality and Outcomes Framework targets for cholesterol (< 5 mmol/l) were achieved by 79% of people in 2006 and 83% in 2013 ( P < 0.001). Baseline age and HbA 1c were associated with death at follow‐up: the odds ratio per year increase in baseline age was 1.10 (95% CI 1.09–1.10; P < 0.001) and per unit increase in HbA 1c it was 1.02 (95% CI 1.02–1.03; P < 0.001). Conclusions Glycaemic control showed remarkable stability over 7 years of follow‐up, despite increasing patient age and duration of diabetes. More patients achieved lipid targets in 2013 than in 2006. Although baseline HbA 1c was a predictor of death at follow‐up, baseline HbA 1c differed little between survivors, non‐survivors and those lost to follow‐up.