Changes in the management of type 2 diabetic patients in family medicine practices in the Bursa region

Abstract

Aim: The aim of the study was to investigate the treatment and monitoring patterns of type 2 diabetes patients in the Bursa region over the last 5 years since the implementation of family practice in Turkey in 2010. Methods: A total of 216 volunteer family doctors working in family health centers took part in this study. The records of 44,819 diabetic patients who visited these doctors between January 1, 2010 and December 31, 2014 were inspected retrospectively. Apart from the identity of the patients, morphometric data, including the type of medication used for diabetes and the HbA1C, serum creatinine and LDL cholesterol values, were recorded. Results: A total of 38.9% (17,416 patients) of the patients in the study were male and 61.1% (27,403 patients) were female. The average age was 59.7 years with a range of 13.2 years. Although the patients' average body mass index (BMI) did not change over the 5 years monitoring, average blood pressure (BP), and serum creatinine and LDL cholesterol levels decreased significantly. The hemoglobin A1c levels were significantly lower after 2010 compared to the 2010 data. Upon examining the medication prescribed for the patients, we determined that the use of metformin and insulin increased, whereas the prescription of thiazolidinedione (glitazone) decreased. There was a significant increase in the amount of patient data recorded over the last 5 years. Conclusions: Despite the increased level of data entry in these patients with type 2 diabetes, the surveillance of diabetes parameters according to treatment guidelines remains suboptimal. There continues to be a need to engage family practitioners on ongoing education and practice enhancement programs.