[Treatment pattern and results in an outpatient population with type 2 diabetes in Iceland.]

Type 2 diabetes mellitus is a major health problem all over the world. The prevalence of the disease is increasing markedly. Healthcare cost associated with type 2 diabetes is high and the long-term diabetic complications account for the greatest proportion of direct cost. Effective control of blood glucose, lipids and blood pressure can delay the development of complications. The purpose of this study was to examine the risk factors, treatment pattern and results in an Icelandic outpatient population with type 2 diabetes. Our results were compared especially with results from Sweden.

Charts were reviewed for all patients (906) with type 2 diabetes that attended the Diabetes Outpatient Clinic at the University Hospital of Iceland in the year 2001. Information about clinical characteristics for the year 2002 were prospectively reviewed for the 380 patients from the year before and for 121 newly diagnosed patients. Clinical characteristics included were age, sex, diabetes duration, glycemic control (HbA1c), office blood pressure, body mass index (BMI), smoking habits, use of lipid- and blood pressure lowering drugs, diabetes treatment and diabetic retinopathy.

Mean age was 66 +/-13.1 (SD) years and the mean age at diagnosis was 57 +/-13.1 (SD) years. Sixty percent were men. The mean body mass index was 29.7 kg/m(2). About 85% of patients had body mass index >25 which is much higher than in 1987 when this proportion was about 67.3%. Mean HbA1c was 7.02 the year 2001 and 6.94% in 2002. The mean cholesterol level was 5.44 mmol/L, HDL 1,22 mmol/L and LDL 3.17 mmol/L in 2002 and 27% were taking lipid lowering drugs in 2002. More patients (61%) reached the blood pressure goal 140/80 mmHg during 2002 than the year before (55%). Sixty five percent were using oral hypoglycemic agents and 17,4% insulin alone. Prevalence of smoking was 13% and of retinopathy 17.1%.

The mean body mass index has been increasing in Iceland as in other western countries. In our survey the mean glycosylated hemoglobin of 7% is somewhat lower than in comparable European surveys, indicating a better glycemic control here. However our survey and comparable surveys indicate that treatment of dyslipidemia and blood pressure has to be more aggressive.