Progression of glycaemia and cardiovascular risk factors in patients of different age groups with new type 2 diabetes over 5 years of follow-up in a diabetes quality improvement initiative

Aims: To examine progression of glycaemia and cardiovascular risk factors in type 2 diabetes cases participating in a quality improvement initiative. Methods: 1108 new type 2 diabetes cases enrolled on the Otago Diabetes Register had clinical data recorded at baseline and 5 years. Means and standard deviations or percentages were calculated for variables of interest for <40, 40-59, 60-79 and 80-100 year age groups. p-Values for differences over time and among groups were calculated. Ordinal regression, with robust standard errors, was used to examine intensification of diabetes treatment. Results: For all age groups blood pressure and lipid levels approached recommended targets at 5 years (p < 0.001). Glycated haemoglobin worsened, especially in the youngest age group (from 7.3 +/- 1.9% to 7.9 +/- 1.7%, p < 0.001) who had the highest odds of more intense diabetes treatment at 5 years: 6.2 (95% CI 3.5-11.2) compared with 3.3 (95% CI 2.7-4.1) for 40-59-year olds, 2.8 (95% CI 2.3-3.3) for 60-79-year olds and 1.4 (95% CI 0.9-2.0) for >= 80-year olds. Conclusions: Good management of type 2 diabetes patients, principally in primary care, can lead to improved blood pressure and lipid levels. Targets for glycaemic control and weight are less readily achieved especially among young age groups. (C) 2011 Elsevier Ireland Ltd. All rights reserved.