Rationale, design and baseline patient characteristics of the optimal type 2 diabetes management including benchmarking and standard treatment study in Greece

Abstract

AIM: To describe baseline data of the optimal type 2 diabetes management including benchmarking and standard treatment (OPTIMISE) study in Greece.

METHODS: “Benchmarking” is the process of receiving feedback comparing one’s performance with that of others. The OPTIMISE (NCT00681850) study is a multinational, multicenter study assessing, at a primary care level, whether using “benchmarking” can help to improve the quality of patient care, compared with a set of guideline-based reference values (“non-benchmarking”). In the Greek region, 797 outpatients (457 men, mean age 63.8 years) with type 2 diabetes were enrolled by 84 office-based physicians. Baseline characteristics of this population are presented.

RESULTS: Hypertension was the most prevalent concomitant disorder (77.3%) and coronary heart disease was the most frequent macrovascular complication of diabetes (23.8%). Most patients were overweight or obese (body mass index 29.6 ± 5 kg/m²), exhibiting mostly abdominal obesity (waist circumference 102.6 ± 13.6 cm). Biguanides were the most prevalent prescribed drugs for the management of diabetes (70.1% of all prescriptions), whereas statins (93.5% of all prescriptions) and angiotensin receptor blockers (55.8% of all prescriptions) were the most prevalent prescribed drugs for hyperlipidemia and hypertension, respectively. Only 37.4% of patients were on aspirin. Despite treatment, pre-defined targets for fasting plasma glucose (< 110 mg/dL), glycated hemoglobin (< 7%), systolic blood pressure (< 130 mmHg and < 125 mmHg for patients with proteinuria) and low density lipoprotein cholesterol levels (< 100 mg/dL and < 70 mg/dL for patients with coronary heart disease) were reached in a relatively small proportion of patients (29%, 53%, 27% and 31%, respectively). In a Greek population with type 2 diabetes, the control of glycemia or concomitant disorders which increase cardiovascular risk remains poor.

CONCLUSION: Despite relevant treatment, there is a poor control of diabetes, hypertension and hyperlipidemia in Greek outpatients with type 2 diabetes.

Keywords: Diabetes, Benchmarking, Treatment target, Glycemic control, Dyslipidemia, Blood pressure

Core tip: This is an epidemiological study assessing the prevalence of comorbidities as well as treatment control in a Greek population of patients with type 2 diabetes. “Benchmarking” is the process of receiving feedback and comparing one’s performance to that of others. The optimal type 2 diabetes management including benchmarking and standard treatment (OPTIMISE) study is a multinational, multicenter study comparing the efficacy of two follow-up strategies in the management of type 2 diabetic outpatients: “benchmarking”vs“non-benchmarking”. This paper describes the rationale and the design of the OPTIMISE study as well as the baseline characteristics of patients included in the Greek region.