Management of Chinese patients with type 2 diabetes, 1998–2006: the Diabcare-China surveys

ABSTRACT

Objective: To describe and compare the differences in subject characteristics, glycaemic control, diabetes complications, and treatment between 1998 and 2006 in patients with type 2 diabetes.

Research design and methods: Subjects who had been registered for diabetes care at the diabetes clinic (defined as any clinic treating over 100 patients/month) for over 12 months were enrolled. The data were retrospectively reviewed, including diabetes history, treatment regimens and laboratory assessments. HbA_1c was measured at a central laboratory. All data were tabulated and statistical analyses were performed.

Results: The Diabcare studies included 2246 subjects (mean age: 59.7 years) in 1998 and 2702 subjects (mean age: 61.9 years) in 2006. The mean duration of diabetes was 8.2 years in 1998 and 8.7 years in 2006 and mean BMI was 23.8 kg/m² in 1998 and 24.6 kg/m² in 2006. The mean glycaemic control improved significantly from 1998 (8.7 ± 2.0%) to 2006 (7.6 ± 1.6%) and significantly more patients reached HbA_1c < 7% or ≤ 6.5% in 2006. The mean fasting plasma glucose (FPG) values were 9.0 ± 3.4 mmol/L in 1998 and 7.7 ± 2.5 mmol/L in 2006. From 1998 to 2006, cataract, neuropathy and background retinopathy remained the most frequently observed diabetes complications. The percentage of the subjects treated with oral antidiabetic drugs (OADs) alone decreased from ∼75% in 1998 to ∼50% in 2006, while the proportion of patients on insulin only and on OADs in combination with insulin was greater in 2006 than 1998. The majority of subjects rated their quality of life as good or acceptable in 2006.

Conclusion: Glycaemic control, diabetes therapy and patient care were improved in 2006. However, the gap between therapeutic guidelines and glycaemic control strongly suggests that promoting awareness of treat-to-target treatment and continuing medical education in clinical practice are still needed.

Key words: :

• China
• Diabetes care
• Glycaemic control
• Type 2 Diabetes

Acknowledgements

Declaration of interest: The Diabcare surveys were sponsored by Novo Nordisk, China. The authors declare that they have no conflicts of interest related to the contents of this article, and acknowledge contributions from the following Novo Nordisk employees: Hong Rao for general coordination of the trial; Ling Cui, Zhongqi Zhang and Xiaowei Ren for technical support with data management and statistical analysis; Reziwanggu Abudula, Jingmei Mao and Yan Zhou for editorial help.

The following members were involved in Diabcare studies in 1998 and 2006: Hui Tian; Xiaoping Chen; Zhengshe Bao; Ning Zhang; Weiping Jia; Wei Liu; Xiaomin Song; Ling Chen; Yanbing Li; Fangping Li; Jicheng Lu; Jinsong Kuang; Guangda Xiang; Yancheng Xu; Shi Zhao; Xiulan Zou; Peiwen Liu; Jing Chen; Zhengping Feng; Mingjun Gu; Xiaochu Deng; Jian Wang; Dalong Zhu; Wenhui Luo; Lirong Sun; Wei Liu; Jingchun Guo; Shiyan Sun; Wanjun Xie; Lihong Wang; Shudong Dai; Dan Wu; Xiaojuan Zhao; Yingzi Luo; Shaowei Liu; Xiangzeng Cai; Jihong Liu; Xingping Sheng; Mingzhu Lin; Haiqu Song; Fangtao Luo; Jinghua Jia; Ruiying Han; Fang Lu; Wu Dai; Ruifang Pu; Kan Hong; Weifeng Yao; Qingfeng Liu; Yulan Li; Yu He; Xueyong Tan; Maoxin Li; Jiangong Ren; Hong Yin; Jun Xu; Xiangming Fang; Chunbei Li; Haiyan He; Zhenzhen Tang.

The following abstracts were published based on aspects of this Diabcare project:

PS1021: Current diabetes care status in China: an observational survey study (DIABCARE 2006) – the 43rd EASD (European Association for the Study of Diabetes) meeting, Amsterdam, the Netherlands, 2007. DWP1-1: Surveillance of type 2 diabetes in China: a subgroup analysis of diabetes duration in the Diabcare 2006 study – the 7th IDF-WPR (International Diabetes Forum-West Pacific Region) meeting, Willington, New Zealand, 2008. 922-P: Diabetes control improvement from 1998 to 2006 among Chinese adults diagnosed with type 2 diabetes: results from Diabcare-China surveys – the 68th ADA (American Diabetes Association) meeting, San Francisco, USA, 2008.

Notes

* Bio-Rad VARIANT, Bio-Rad Laboratories, Hercules, CA, USA