[Totally reimbursed care for type 2 diabetes in 1994: characteristics and follow-up]

Non-insulin-dependent diabetes mellitus (NIDDM) is an important health issue in France. According to projections from current data, the problem should increase over the upcoming years. The aim of this study was to determine the characteristics of patients with NIDDM who are enrolled on the list of 30 long term diseases (ALD30) and examine their follow-up and disease-related complications. This study was performed with the data base established by the French National Health Insurance for Salaried Workers (CMANTS) in 1994. Diagnosis and medical information were coded by official physicians, who either examined the patients or consulted their primary care physician (69% of the cases), or relied on available medical records. Eight thousand two hundred forty-seven patients (sex ration=0.95) with NIDDM enrolled on the long term disease list were included. Mean age was 65.1+/- 0.13 years (m+/- SEM). More than one blood glucose level per year was available for 89% of the patients and an HA1c assay in only 34%. In addition, for patient follow-up at least once a year, 80%, 47%, and 42% of the patients had a serum creatinine assay, a funus examination, or an electorcariogram respectively. Irrespective of the criteria retained (fasting glucose=1.26 g/l; fasting glucose=1.40 g/l) there was a high percentage of patients whose level was well above the limit (75% and 63% respectively). For HbA1c, only a quarter of the patients had values lower than the limits defined by the ANAES and AFFSAPS guidelines. The percentage of diabetic patients without complications was 41% (hypertension excluded). The most frequently observed complications isolated peripheral vascular conditions (31%). These results were obtained from a database created in 1994, before guidelines on type 2 diabetes were officially published. They can serve as a reference to follow medical practices.