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Primary care management of diabetes mellitus in five European countries.
Donker, G.A., Fleming, D.M., Schellevis, F.G., Spreeuwenberg, P. Primary care management of diabetes mellitus in five European countries. European Journal of Public Health: 2004, 14(4 Suppl.) 42. Abstract. 12 th Annual EUPHA meeting: Urbanisation and health: new challenges in health promotion and prevention in Oslo, Norway, 7-9 october 2004.
Aim: To compare management of DM in general practice in five European countries in order to assess whether differences in management of DM can be related to differences in national guidelines for general practitioners (GPs) and to differences in health care system.Methods Retrospective study in general practice during a 12 months period (1999/2000). Routine monitoring of patients presenting with DM to GPs in established sentinel practice surveillance networks in five European countries (Belgium, Croatia, England, Spain and The Netherlands). Results were stratified by age and country. Results: The proportion of patients treated by: diet only vary from 13% (The Netherlands) to 25% (Spain); diet and oral antidiabetics from 51% (UK) to 62% (Belgium); a combination of diet and insulin varied from 15% (Belgium and Croatia) to 26% (The Netherlands); a combination of diet, oral antidiabetics and insulin less than 10% in all countries. In the older age groups insulin is prescribed most frequently in The Netherlands. Spain and Croatia show high consultation rates for DM; UK and The Netherlands low rates. Referral percentages vary considerably between countries (highest in Croatia). Conclusions: There are national differences in the management of DM. Insulin is used more extensively in The Netherlands where guidelines are well established. Consideration should be given to an international approach to disease management of DM with guidelines firmly and solely based on evidence.
Aim: To compare management of DM in general practice in five European countries in order to assess whether differences in management of DM can be related to differences in national guidelines for general practitioners (GPs) and to differences in health care system.Methods Retrospective study in general practice during a 12 months period (1999/2000). Routine monitoring of patients presenting with DM to GPs in established sentinel practice surveillance networks in five European countries (Belgium, Croatia, England, Spain and The Netherlands). Results were stratified by age and country. Results: The proportion of patients treated by: diet only vary from 13% (The Netherlands) to 25% (Spain); diet and oral antidiabetics from 51% (UK) to 62% (Belgium); a combination of diet and insulin varied from 15% (Belgium and Croatia) to 26% (The Netherlands); a combination of diet, oral antidiabetics and insulin less than 10% in all countries. In the older age groups insulin is prescribed most frequently in The Netherlands. Spain and Croatia show high consultation rates for DM; UK and The Netherlands low rates. Referral percentages vary considerably between countries (highest in Croatia). Conclusions: There are national differences in the management of DM. Insulin is used more extensively in The Netherlands where guidelines are well established. Consideration should be given to an international approach to disease management of DM with guidelines firmly and solely based on evidence.