Scandinavian journal of primary health care · 2012
How to diagnose and classify diabetes in primary health care: lessons learned from the Diabetes Register in Northern Sweden (DiabNorth).
СтатьяПоддержка исследования: вне правительства СШАВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Rolandsson Olov, Norberg Margareta, Nyström Lennarth, Söderberg Stefan, Svensson Maria, Lindahl Bernt, Weinehall Lars
Аннотация
OBJECTIVE: The objective was to create a diabetes register and to evaluate the validity of the clinical diabetes diagnosis and its classification.
DESIGN: The diabetes register was created by linkage of databases in primary and secondary care, the pharmaceutical database, and ongoing population-based health surveys in the county. Diagnosis and classification were validated by specialists in diabetology or general practitioners with special competence in diabetology. Analysis of autoantibodies associated with type 1 diabetes was used for classification.
SETTING: Primary and secondary health care in the county of Västerbotten, Sweden.
PATIENTS: Patients with diabetes (median age at diagnosis 56 years, inter quartile range 50-60 years) who had participated in the Västerbotten Intervention Programme (VIP) and accepted participation in a diabetes register.
RESULTS: Of all individuals with diabetes in VIP, 70% accepted to participate in the register. The register included 3256 (M/F 1894/1362) diabetes patients. The vast majority (95%) had data confirming the diabetes diagnoses according to WHO recommendations. Unspecified diabetes was the most common (54.6%) classification by the general practitioners. After assessment by specialists and analysis of autoantibodies the majority were classified as type 2 diabetes (76.8%). Type 1 diabetes was the second largest group (7.2%), including a sub-group of patients with latent autoimmune diabetes (4.8%).
CONCLUSION: It was concluded that it is feasible to create a diabetes register based on information in medical records in general practice. However, special attention should be paid to the validity of the diabetes diagnosis and its classification.
DESIGN: The diabetes register was created by linkage of databases in primary and secondary care, the pharmaceutical database, and ongoing population-based health surveys in the county. Diagnosis and classification were validated by specialists in diabetology or general practitioners with special competence in diabetology. Analysis of autoantibodies associated with type 1 diabetes was used for classification.
SETTING: Primary and secondary health care in the county of Västerbotten, Sweden.
PATIENTS: Patients with diabetes (median age at diagnosis 56 years, inter quartile range 50-60 years) who had participated in the Västerbotten Intervention Programme (VIP) and accepted participation in a diabetes register.
RESULTS: Of all individuals with diabetes in VIP, 70% accepted to participate in the register. The register included 3256 (M/F 1894/1362) diabetes patients. The vast majority (95%) had data confirming the diabetes diagnoses according to WHO recommendations. Unspecified diabetes was the most common (54.6%) classification by the general practitioners. After assessment by specialists and analysis of autoantibodies the majority were classified as type 2 diabetes (76.8%). Type 1 diabetes was the second largest group (7.2%), including a sub-group of patients with latent autoimmune diabetes (4.8%).
CONCLUSION: It was concluded that it is feasible to create a diabetes register based on information in medical records in general practice. However, special attention should be paid to the validity of the diabetes diagnosis and its classification.