Clinical characteristics of diabetic patients transferred to Korean referral hospitals

Clinical characteristics of diabetic patients transferred to Korean referral hospitals
2,4 thiazolidinedione derivative; alpha glucosidase inhibitor; angiotensin 2 receptor antagonist; antithrombocytic agent; beta adrenergic receptor blocking agent; calcium channel blocking agent; dipeptidyl carboxypeptidase inhibitor; dipeptidyl peptidase IV inhibitor; diuretic agent; fibric acid derivative; glucose; hemoglobin A1c; hydroxymethylglutaryl coenzyme A reductase inhibitor; insulin; metformin; sulfonylurea; adult; Article; blood glucose monitoring; cerebrovascular accident; comorbidity; coronary artery disease; diabetes mellitus; diabetic nephropathy; diabetic neuropathy; diabetic patient; diabetic retinopathy; dyslipidemia; female; glycemic control; hemoglobin blood level; hospital; human; hypertension; Korea; major clinical study; male; nursing home; patient education; patient preference; patient transport; peripheral occlusive artery disease; prevalence; public health service; retrospective study; secondary care center
Issue Date
Diabetes and Metabolism Journal, v.38, no.5, pp.388 - 394
Background: We evaluated the disease profile and clinical management, including the status of both glycemic control and complications, in patients with diabetes who were transferred to referral hospitals in Korea. Methods: Patients referred to 20 referral hospitals in Gyeongsangnam/Gyeongsangbuk-do and Jeollanam/Jeollabuk-do with at least a 1-year history of diabetes between January and June 2011 were retrospectively reviewed using medical records, laboratory tests, and questionnaires. Results: A total of 654 patients were enrolled in the study. In total, 437 patients (67%) were transferred from clinics and 197 (30%) patients were transferred from hospitals. A total of 279 patients (43%) visited higher medical institutions without a written medical request. The main reason for the referral was glycemic control in 433 patients (66%). Seventy-three patients (11%) had received more than one session of diabetic education. Only 177 patients (27%) had been routinely self-monitoring blood glucose, and 146 patients (22%) were monitoring hemoglobin A1c. In addition, proper evaluations for diabetic complications were performed for 74 patients (11%). The most common complication was neuropathy (32%) followed by nephropathy (31%). In total, 538 patients (82%) had been taking oral hypoglycemic agents. A relatively large number of patients (44%) had been taking antihypertensive medications. Conclusion: We investigated the clinical characteristics of diabetic patients and identified specific problems in diabetic management prior to the transfer. We also found several problems in the medical system, which were divided into three medical institutions having different roles in Korea. Our findings suggested that the relationships among medical institutions have to be improved, particularly for diabetes. ? 2014 Korean Diabetes Association.
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