Prevalence of diabetes and frequency of glycated haemoglobin monitoring in Extremadura (Spain) during 2012, 2013 and 2014: An observational study

Effect of a Disease Management Program on the Adherence to Guideline-Recommended HbA1c Monitoring in Patients with Diabetes in Slovakia

“…In our study in Slovakia in 2019, HbA1c levels were tested an average of 2.1 times per year in patients with T1D or T2D, a frequency that is notably higher than that reported in a number of other developed countries. For example, in Spain, HbA1c testing occurred an average of 0.9 times per year [ 16 ]; in the Canadian province of Alberta, patients with diabetes had their HbA1c tested more frequently, averaging 1.5 times per year [ 17 ]; and in a German study in 2016, HbA1c levels in T2D patients were reported to be tested at the even higher frequency of 2.7 times on average [ 18 ]. In yet another study involving 15,199 patients with T1D from Germany and Austria, quarterly HbA1c testing was associated with the best metabolic control [ 15 ].…”

Prevalence of Chronic Kidney Disease in Patients with Diabetes in Extremadura (Spain) during the Years 2012, 2013 and 2014: An Observational Study

“…We performed an observational, retrospective, prevalence study, with the information gathered, during 2012, 2013 and 2014, in two databases from the Extremadura Health System: one about medication dispensed in pharmacies, and another about clinical analyses (CORNALVO). Patients, ≥18 years old with DM criteria were identified as previously reported [12] (90,709; average age 68.3 ± 14.1 years; 50.2% women). Among them, in the three-year period studied, 76,408 patients (mean age 68.2 ± 14.0 years; 50.3% women) had at least one serum creatinine determination, and 46,129 patients (mean age 66.9 ± 13.9 years; 49.8% women) had at least one creatinine and albumin determination in urine.…”

“…The identification of patients with diabetes was carried out with diagnostic criteria based on hypoglycemic drug use and hemoglobin A 1C values and not through the review of patients' medical history [12]. This strategy has the advantage of identifying a large number of patients with hidden diabetes, but the disadvantage is that the adopted diagnostic criteria will also include as diabetic patients a small number of patients who might have a prescription for antidiabetic drugs for an indication other than diabetes, for example, polycystic ovarian syndrome (metformin), obesity (metformin and incretin analogues), or gestational diabetes (metformin, insulin) [12]. Moreover, the databases used for the study do not contain data about possible urine sediment abnormalities, imaging abnormalities, kidney transplantation or pathologic abnormalities.…”

“…The existence of a subgroup of the population in whom UACR is not measured, also needs to be emphasized from a population health perspective, given that diabetes is a condition characterized by glomerular hyperfiltration and albuminuria is a marker of renal damage, that precedes a fall in GFR. Accordingly, these results also force us to review the quality of care provided to patients with DM in Extremadura (Spain) [12].…”

“…An early recognition of risk factors for CKD progression can be decisive in decreasing morbidity and mortality, and a timely nephrological evaluation can also guarantee adequate information to choose the right renal replacement therapy at the right time in case of renal impairment progression. Therefore, it is necessary to re-evaluate the quality of care received by the diabetic population in Extremadura (Spain) [12]. A systematic determination of eGFR and UACR would contribute to earlier diagnosis of CKD, thus allowing intervention in the early stages of the disease where treatment is more effective.…”