Diabetologie und Stoffwechsel 2019; 14(S 01): S10
DOI: 10.1055/s-0039-1688132
ePoster
Digitalisierung und neue Technologien
Georg Thieme Verlag KG Stuttgart · New York

Guideline-adherence beyond HbA1c: Status of risk-adjusted care for type-2-diabetes patients with hypertension and kidney disease enrolled in a digital platform (PDMone)

S Brenner
1   UMIT – Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik GmbH, Institut für Management und Ökonomie im Gesundheitswesen, Hall in Tirol, Austria
,
R Daikeler
2   Internistische Gemeinschaftspraxis, Diabetologische Schwerpunktpraxis, Sinsheim, Germany
,
B Kulzer
3   Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
,
A Reichel
4   Universitätsklinikum 'Carl Gustav Carus' der Technischen Universität Dresden, Medizinische Klinik und Poliklinik III, Dresden, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
07 May 2019 (online)

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Background:

Cardiovascular complications remain the primary cause of death for type-2-diabetes patients (T2DM). Guidelines recommend tight monitoring of blood pressure and kidney function for high-risk patients, in addition to HbA1c. The Steno-2 trial impressively demonstrated that patients with kidney disease greatly benefit from comprehensive risk-factor management. Here, we show how this guidance is implemented in specialist diabetes care and how its use correlates with outcomes.

Methods:

A 9+ month, observational quality management study yielded data from 9 centers and 123 T2DM-patients due for insulin treatment intensification. Anamnestic and lab data were recorded using a digital platform for personalized diabetes management (PDMone, Roche Diabetes Care). High-risk patients with concomitant hypertension and kidney disease (incl. microalbuminuria) were selected for analysis (n = 67). Guideline-adherent risk-factor management was assumed if the personalized Systolic Blood Pressure (SBP) target was ≤130 mmHg and/or BP-lowering medications (RAS- inhibitor) were prescribed. The descriptive analysis focused on the association of medical outcomes with guideline adherent disease management.

Results:

The analysis shows that 29% of high-risk T2DM-patients were not treated according to guidelines. 50% of these patients did not achieve SBP levels of ≤130 mmHg – compared to only 22% in the adherent group. Blood-glucose-levels and HbA1c were not negatively affected by tightened cardiovascular risk-factor management.

Conclusion:

Almost one third of patients were not provided with comprehensive risk-oriented therapy. To achieve higher levels consistently, key information needs to be integrated and made available. The analysis underlines: PDMone can support physicians in monitoring the care process and facilitate guideline-adherent disease management.