Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Trends in blood glucose levels and management of diabetes in 467,955 patients in primary care in Australia from 2005 to 2013 (#11)

Neale Cohen 1 , Tracey Gerber 2 , Yih Kai Chan 2 , Simon Stewart 2 , Melinda Carrington 2
  1. Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
  2. BakerIDI Heart and Diabetes Institute, Melbourne , VIC, Australia

A rise in the incidence of diabetes mellitus has been reported worldwide over the last decade. Treatment and management is generally delivered in primary care in Australia but recent trends in blood glucose levels and management within this setting are unknown. The aim of this study was to examine glycated haemoglobin (HbA1c) and fasting glucose levels in association with hypoglycaemic prescription patterns in patients attending primary care in Australia.

Preliminary data from a national registry of clinical contacts and associated use of medicines in 320 clinics from metropolitan and regional locations between 2005 and 2013 were analysed.

A total of 467,955 patients (55% women, aged 55.4 ± 19.7 years) seen by 945 general practitioners had glucose testing. Over this time, there were a total of 1,296,396 visits where HbA1c or fasting glucose was measured. At first presentation, average HbA1c and glucose was 7.1 ± 1.7% (annual range 6.9 to 7.3%) and 5.5 ± 1.8 mmol/L (annual range 5.4 to 5.7 mmol/L), respectively. There was little change in HbA1c and glucose measurements between 2005 and 2013. Overall, men had higher HbA1c (7.2 ± 1.8 vs. 7.0 ± 1.7%,p<0.001) and glucose levels (5.7 ± 2.0 vs. 5.3 ± 1.6 mmol/L, p<.001). HbA1c values were ≥ 7.0% for 42% of individuals and less likely to be elevated in women than men (OR 0.80; 95% CI 0.77-0.83, p<.001). HbA1c and glucose measurements were higher in adults living in regional compared to urban locations (HbA1c: 7.2 ± 1.8 vs. 7.1 ± 1.7%, p<.001; Glu: 5.5 ± 1.8 vs. 5.4 ± 1.8 mmol/L, p<.001).

Preliminary findings from the largest study of glucose monitoring in primary care in Australia to date show limited progress over the past decade in reducing glucose levels. Greater effort to improve glucose levels to halt the rise in highly preventable diabetes and associated end organ damage is necessary. Further analyses in relation to treatment effects and ongoing management are planned.

Study sponsored by Sanofi