The association between glycemic, lipids and blood pressure control among Israeli diabetic patients

Abstract

Background: It is recommended that in diabetes mellitus patients all risk factors for cardiovascular disease should be controlled. Aim: To evaluate the rate of reaching all glycemic, lipids and blood pressure target levels among diabetic patients in Israel and to analyze demographic and clinical parameters associated with it. Design: A cross-sectional study. Methods: The study was conducted in Maccabi Healthcare Services, Israel's second largest health maintenance organization. All patients (n=41 936), older than 20 years, who were listed on Maccabi Healthcare Service's diabetes mellitus computerized database and had all three study parameters (HbA1c, LDL-C and blood pressure levels during 2005) were eligible for the study. The rate of reaching HbA1c <7.0%, LDL-C <100 mg/dl and blood pressure <130/85 mmHg, as well as its association with various demographic and clinical parameters were analyzed. Results: Only 13% of all study patients achieved all three target levels. The parameters which were significantly associated with goal achievement were compliance to medical treatment for all three parameters (OR 1.56, 95% CI 1.44-1.69, P=0.0001), male gender (OR 1.42, 95% CI 1.31-1.54, P=0.0001), comorbidity with ischemic heart disease (OR 1.23, 95% CI 1.13-1.34, P=0.0001), and >12 visits per year to family physician (OR 1.10, 95% CI 1.02-1.19, P=0.012). Conclusion: Non-compliance with treatment and sub-optimal follow-up by family physicians are associated with increased risk of failure to control major risk factor among diabetic patients. © The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.