Glycaemic Control In Niddm Patients And Its Relation To Inpatient Care Utilisation, Short-Term Sick-Leave And Premature Retirement

The aim of this study was to assess the relationship between glycaemic control, on the one hand, and short-term sick-leave, premature retirement and inpatient care requirement, on the other in patients with non-insulin dependent diabetes mellitus (NIDDM), A cross-sectional study model was applied to NIDDM patients from a Swedish primary health care centre, Inpatient care and short-term sick-leave were recorded as cumulative incidence in 1991, Prevalence of premature retirement was recorded at 31 December 1991, Clinical information on glycaemic control, i.e., HbA(1c) levels, blood pressure, and body weight were obtained from a computerised medical record system, All HbA(1c) determinations were performed at the same laboratory using an HPLC-method. HbA(1c) level was significantly higher (7.8 % vs 6.8%) in patients who utilised inpatient care than in those who did not. No association with the HbA(1c) level was found for sick-leave or premature retirement. Therefore it seems reasonable to assume that glycaemic control is more predictive of clinical complications in elderly NIDDM patients than in younger ones. However, as vascular complications from poor glycaemic control develop slowly and gradually, poor glycaemic control even in younger patients may eventually result in an increased need of impatient care, Accordingly, the lack of relationship between HbA(1c) and risks of premature retirement and short-term sick-leave in patients younger than 65 should not be used as an excuse for less aggressive treatment of younger NIDDM patients.