Appendix 4 : Guidelines Reports

Page last updated: 27 September 2012

NADC - ANDIAB
Australian National Diabetes Information Audit & Benchmarking



Final Report
ANDIAB 2011
[December 2011]



Guidelines Summary Report :


The following pages provide a Guidelines Summary Report for the data All Sites based on the NSW Health Principles of Care and Guidelines for the Clinical Management of Diabetes Mellitus (1996).

Image showing Demographic and Management Details and Image is not properly visible
The purpose of this image is to provide an example of Demographic and Management Details.

Disclaimer

This website is presented by the Department of Health and Ageing (DoHA) for the purpose of disseminating information free of charge for the benefit of the public.

DoHA does not guarantee and accepts no legal liability whatsoever arising from or connected to the accuracy, reliability or completeness of this above image showing Demographic and Management Details which is not properly visible.

Image showing Data reported against NSW Clinical Management Guidelines for Diabetes and Image is not properly visible
The purpose of this image is to provide an example of Data reported against NSW Clinical Management Guidelines for Diabetes.

Disclaimer

This website is presented by the Department of Health and Ageing (DoHA) for the purpose of disseminating information free of charge for the benefit of the public.

DoHA does not guarantee and accepts no legal liability whatsoever arising from or connected to the accuracy, reliability or completeness of this above image showing Data reported against NSW Clinical Management Guidelines for Diabetes which is not properly visible.


Top of page
Each Section states the individual guideline, then provides analysis of the data for All Sites.

Guideline 4 :- Blood Pressure
Image of ClockMeasure every clinical visit
Image of Target18-39 yrs Target < 140/90
40-60 yrs Target 140 – 160/90
>60 yrs Target < 160/90

This section states the individual guideline

n% of patients
All Patients with BP measured in the last 12 months36398.4
Adult Patients with BP measured in the last 12 months and age available36197.8

This section provides analysis of the data for All Sites

Age Resultn% of patients with BP result
BP at last measurement18 -39 yrs < 140/9040 97.6
BP at last measurement18 -39 yrs=>140/9012.4
BP at last measurement40-60 yrs<160/908782.1
BP at last measurement40-60 yrs=>160/901917.9
BP at last measurement> 60 yrs<160/9015873.8
BP at last measurement> 60 yrs=>160/905626.2

NADC - ANDIAB 2011 Guidelines Report
All Sites - All Doctors



Forms have completed date 1/01/2011 - 7/12/2011
Total number of adult patients: 4629
Number of patients in this report : 4629


Mean Age of Persons with Diabetes: 57.2 Years (n= 4580)
Age Range 3.8 - 99.4
Years Percentage of Males: 53.5 %
Percentage Of Females: 46.0%
Percentage Sex Incomplete 0.5 %

Management Details


Mean age patients developed diabetes 43.6 Years (n= 4435)
Mean duration of patients diabetes: 13.9 Years
Range: 0 - 64.4 Years
Top of page

Diabetes Type:

Type 2 (Non Insulin dependent diabetes): 72.5 %
Type 1 (Insulin dependent diabetes): 22.7%
GDM (Gestational diabetes): 1.9 %
Unknown: 0.3%
Incomplete*: 2.6%

Method of Diabetes Management:-

Diet only: 4.5%
Tablets: 26.6%
Insulin: 35.8%
Tablets and Insulin: 29.7%
Nil Treatment: 0.0%
Incomplete*: 3.4%
*[Incomplete means missing or unknown]

Diabetes Guidelines

* Data are reported against the NSW Health Principles of Care and Guidelines for the Clinical Management of Diabetes Mellitus (1996) for comparison with previous reports as well as against NHMRC Type 2 diabetes guidelines

Guideline 1 Blood Glucose Control

Image of Clock Measure every 3 - 6 months for insulin treated patients
Image of ClockMeasure every 6 - 12 months for non-insulin treated patients
Image of TargetTarget within 1% of upper limit of normal (eg 7% when normal range 4 - 6%)


n% of patients
Patients with HbA1c measured in the last 12 month424491.7


Resultn% of patients with HbA1c
HbA1c at last measurement
<1% > NUR
1281
30.2
HbA1c at last measurement
>1 - 2% > NUR
115627.2
(NUR = normal upper range from patient data) > 2%> NUR180742.6
HbA1c at last measurement <10/0 > NUR00.0
(No NUR available from patient data - NUR of 6% assumed) >1 - 2% > NUR00.0
(No NUR available from patient data - NUR of 6% assumed) > 2 % > NUR00.0
Top of page

Guideline 2 Diabetic Eye Disease


Image of Clock For patients with Type 1: Initial assessment 5 years post diagnosis and then annually
Image of ClockFor patients with Type 2: At diagnosis and then annually
Image of TargetTarget to identify individuals who have treatable retinopathy to prevent visual impairment and blindness


n
% of patients
Patients who have attended an Ophthalmologist in the last 12 months
1897
41.0
Patients who have attended an Optometrist in the last 12 months
1764
38.1
Patients who have attended either in the last 12 months
3034
65.5

Guideline 3 Weight


Image of ClockMeasure three monthly or more frequently if on a weight reduction program
Target to reduce and maintain body mass index (BMI) below the critical level of 27.0 kg/mē .


n% of patients
Patients with weight measured in the last 12 month445596.2
Patients with height measured405586.5
Patients with BMI calculated in the last 12 months398886.2


ResultnType 1 with BMIWith Diabetes
n
% with BMIWith Type 2 Diabetes n% with BMI
BMI at last measurement (kg/m2)Males: =< 2761228.626358.233220.3
BMI at last measurement (kg/m2)Males: > 27152771.418941.8130079.7
BMI at last measurement (kg/m2)Females:= < 2754829.824859.325719.7
BMI at last measurement (kg/m2)Females: > 27129070.217040.7104980.3

Top of page

Guideline 4 Blood Pressure


Image of ClockMeasure every clinical visit
Image of Target 18- 39 yrs target <140 / 90 Image of Target NHMRC Guidelines target <= 130 / 80
40 - 60 yrs target 140- 160 / 90
> 60 yrs target < 160 / 90


n% of patients
All Patients with BP measured in the last 12 months448496.9
Adult Patients with BP measured in the last 12 months & Age available440095.1

BP at last measurement in different age groups

Age
Result
n
% of patients
with BP result
<= 130 / 80
2381
53.1
> 130 / 80
2103
46.9
      18 - 39 yrs
<140 / 90
660
88.5
      18 - 39 yrs
=> 140 / 90
86
11.5
      40 - 60 yr
< 160 / 90
1149
84.0
      40 - 60 yr
=> 160 / 90
219
16.0
      >60 yr
<160 / 90
1994
87.2
>60 yr
=> 160 / 90
292
12.8


Guideline 5 Diabetic Foot Problems (Adult Forms)


Image of ClockMeasure every 6 months if no active foot problems
Image of ClockMeasure every visit if high risk foot or active foot problems
Image of TargetTarget to identify the "high risk foot", active foot problems and prevent non-traumatic amputations


n% of patients
Patients identified with "high risk foot"
1295
28.0
Patients who have attended Podiatrist in the last 12 months
1617
34.9
Patients identified with "high risk foot" who have attended Podiatrist in
the last 12 months
696
15.0

Top of page

Guideline 6:- Lipids


Measure every 12 months if normal
Measure every 3 - 6 months if abnormal or on treatment
Cholesterol: target < 5.5mmol/L, if pre-existing CVD target <4 5mmol/L
Triglycerides: target < 2.0mmol/L
HDL: target => 1.0mmol/L


NHMRC Guidelines target:
Cholesterol: Target < 5 0 mmol/L
LDL: Target < 2 5 mmol/L

*[Lipids measured means at least a Cholesterol level recorded]

n% of patients
Patients with fasting lipids measured in the last 12 months Patients
2449
52.9
with lipids measured in the last 12 months (not fasting)
511
11.0
Patients with lipids measured in the last 12 month (fasting unknown)
736
15.9
Patients with lipids not measured in the last 12 months
933
20.2

Result

Lipids at at last measurement

Fasting

n
Fasting

% with
Lipid result
Not Fasting

n
Not Fasting

% with
Lipid result
Fasting Unknown

n
Fasting Unknown

% with
Lipid result
Total Cholesterol (mmol/L): <5.0
1894
77.0
257
50.0
587
35.0
<5.5
2122
86.6
309
60.5
654
39.2
[5.5 - 6.5]
207
8.5
52
10.2
58
3.5
>6.5
87
3.6
13
2.5
24
1.4
Incomplete*
33
1.3
137
26.8
933
55.9
Triglycerides (mmol/L): <2.0
1680
68.6
232
45.4
511
30.6
[2.0 - 4.0]
585
23.9
112
21.9
180
10.8
>4.0
129
5.3
22
4.3
36
2.2
Incomplete*
55
2.2
145
28.3
942
56.4
HDL Cholesterol (mmol/L): <1.0
611
24.9
67
13.1
168
10.1
> 1.0
1561
63.7
181
35.4
479
28.7
Incomplete*
277
11.3
263
51.4
1022
61.2
LDL Cholesterol (mmol/L): <2.5
1342
55.0
128
25.0
418
25.0
> 2.5
702
29.0
107
21.0
185
11.0
Incomplete*
405
16.0
276
54.0
1066
64.0

*[Incomplete means missing or unstated in this category]
Top of page

Guideline 7:- Diabetic Nephropathy


Measure initially 5 years post diagnosis and then annually for Type 1 patients
Measure at diagnosis and annually for Type 2 patients
Target is to identify and treat individuals with microalbuminuria

[Data assumes ranges stated below if Upper Limit data is missing]


n
Patients with urine collected in the last 12 months302665.4


Result
Result
Patients with
Units and
Upper Limit
Patients with
missing
Upper Limit
Patients with Microalbumin result
n
Patients with Microalbumin result
%
uAlbumin at last measurementNormal
1423
149
1572
51.9
uAlbumin at last measurementMicroalbuminuria
608
70
678
22.4
uAlbumin at last measurementMacroalbuminuria
277
22
299
9.9
uAlbumin at last measurementProteinuria
21
3
24
0.8
uAlbumin at last measurementPatients with missing Units
453
453
15.0
uAlbumin at last measurementTotal
2329
697
3026
100.0

uAlbumin Ranges:mg/Lug/minratiomg/24hr
Normal< 30< 20< 3.0<= 300
Microalbuminuria30 - 30020 - 2003.0 - 30
Macroalbuminuria> 300> 200> 30
Proteinuria> 300


Wednesday, 30 November 2011

Top of page