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DOI: 10.1055/s-2008-1078734
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Time Trends in Type 2 Diabetes Patients’ Disease Management and Outcomes: Evidence from Two KORA Surveys in Germany
Publication History
received 21.04.2008
first decision 15.05.2008
accepted 15.05.2008
Publication Date:
25 August 2008 (online)
Abstract
To explore time trends in diabetes management and intermediate health outcomes of people with type 2 diabetes, data from two population-based survey studies were compared. The surveys were conducted in the Augsburg region of Southern Germany in 1997/98 and in 2004/05, and included physical examinations, interviews, self-administered questionnaires and laboratory tests. Data from 334 participants aged 40–84 were analysed, including a longitudinal sub-sample of 50 persons. Results show significant time trends towards improvements over the seven year period. Controlling for age, sex, education and duration of diabetes, people felt better informed about diabetes (Odds Ratio (OR) 1.87; 95% CI: 1.12, 3.14) and stated greater adherence to the treatment plan (OR 4.42; CI: 2.62, 7.45) as well as higher participation in diabetes education programmes (OR 2.20; CI: 1.44, 3.38). Mean haemoglobin A1c levels decreased by −0.97% from 7.3% to 6.3% (CI:−0.66%, −1.28%). Physical activity (≥1 h/week) was more frequent (OR 2.75; CI: 1.65, 4.59), although Body Mass Index increased by 1.43 kg/m2 (CI: 0.86, 2.00). The positive changes in disease management and metabolic outcomes for type 2 diabetic patients between 1997/98 and 2004/05 indicate a shift towards greater patient involvement in diabetes care and possibly more efficient medical management practices.
Key words
time trends - type 2 diabetes - disease management - glycaemic control - KORA - Germany
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Correspondence
Dr. M. SchunkMPH
Institute of Health Economics and Health Care Management
Helmholtz Zentrum München
German Research Center for Environmental Health (GmbH)
P.O. Box 1129
85758 Neuherberg
Phone: +49/89/3187 41 69
Fax: +49/89/3187 33 75
Email: michaela.schunk@helmholtz-muenchen.de