Analysis of typical approaches to outpatient management of type 2 diabetes mellitus
Aim. To analyze typical outpatient management approaches to type 2 diabetes mellitus (T2DM). Materials and Methods. We analyzed 211 files from 7 outpatient clinics, containing case records of patients, regularly examined during 2009. VEN, ABC- and frequency analyses were conducted. Results. Prescription percentage for medications with proved prognosis improvement did not substantially differ from recommended level. Main direct expenditures were related to antihyperglycemic, antihypertensive and hypolipidemic agents (class V). Inexpensive medications without proven efficiency (class N) were prescribed more frequently than those with capacity to improve quality of life (class E). Testing for HbA1c level was found to be of inadequate frequency and thus complicated assessment of antihyperglycemic treatment efficacy. Number of patients with improvement in arterial hypertension showed an increase, but treatment goals were not achieved in 2/3 of patients (according to office measurement). Prescription frequency of statins, though growing in the course of year, remained insufficient; rare testing for LDL complicated assessment of hypolipidemic treatment adequacy. Conclusion. Structure of pharmacological treatment is fairly adequate, but goals of multifactor therapy are not achieved in a significant percentage of patients, which may be explained by peculiarities of diabetes pathogenesis, prescription of inadequate treatment regimens and doses and insufficient dynamic control.