Diabetes Metab J.  2014 Oct;38(5):388-394. 10.4093/dmj.2014.38.5.388.

Clinical Characteristics of Diabetic Patients Transferred to Korean Referral Hospitals

• Oh MY
• Kim SS
• Kim IJ
• Lee IK
• Baek HS
• Lee HW
• Chung MY

• KMID: 2280683
• DOI: http://doi.org/10.4093/dmj.2014.38.5.388

Abstract

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.

Keyword

Diabetes mellitus; Korea; Referral and consultation

MeSH Terms

Blood Glucose
Diabetes Complications
Diabetes Mellitus
Education
Humans
Hypoglycemic Agents
Korea
Medical Records
Referral and Consultation*
Retrospective Studies
Surveys and Questionnaires
Blood Glucose
Hypoglycemic Agents

Figure

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  Fig. 1 Prevalence of diabetic complications in referred patients. The prevalence of macrovascular complications, including coronary artery disease (CAD), stroke, and peripheral artery disease (PAD), was lower than that of microvascular complications, including diabetic retinopathy, nephropathy, and neuropathy.

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