QJM Advance Access originally published online on February 23, 2008
QJM 2008 101(4):275-280; doi:10.1093/qjmed/hcm150
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The association between glycemic, lipids and blood pressure control among Israeli diabetic patients
From the 1Department of Medicine, Meir Medical Center, Kfar Saba, 2Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv and 3Maccabi Healthcare Services, Tel-Aviv, Israel
Address correspondence to Avishay Elis, Department of Medicine "A", Meir Medical Center, Kfar Saba, Israel. email: avishayel{at}clalit.org.il
Received 3 July 2007 and in revised form 29 October 2007
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Abstract |
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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.