The proposed EHR-based approach will quantify the T2DM severity for primary care performance management and inform the methodology for measuring severity of other primary care-managed chronic conditions .
INTRODUCTION The increasing prevalence of type 2 diabetes mellitus ( T2DM ) presents a significant burden on affected individuals and healthcare systems internationally .
There is , however , no agreed vali date d measure to infer diabetes severity from electronic health records ( EHRs ) .
We aim to quantify T2DM severity and vali date it using clinical adverse outcomes .
Diabetes control and complications in private primary healthcare in Malaysia.
This Diabcare-Asia project was initiated to study the status of diabetes care and prevalence of diabetic complications in Asia and this study was done to evaluate the above in primary private healthcare in Malaysia . A total of 49 private clinics participated in this study from which a total of 438 patients were included and analysed . The majority of patients ( 96.5 % ) had type 2 diabetes mellitus and 81.4 % had BMI > or = 23 kg/m2 . Only 12.0 % of the patients had their HbA1c measured in the preceding 12 months . As for glycaemic control only 20 % of the patients had HbA1c < 7 % and 11 % had FPG < 6.7 mmol/L. As for lipid levels , only 12.3 % of the patients had total cholesterol < 4.8 mmol/L ; 30.9 % had HDL-cholesterol > 1.2 mmol/L and 49.8 % had triglycerides < 1.7 mmol/L. Despite the high proportion of patients having dyslipidaemia . only 12.4 % of the patients were on lipid lowering therapy . As for blood pressure , 55.9 % of the patients had systolic pressure > or = 140 mmHg and 40.9 % had diastolic pressure > or = 90 mmHg . However , only 32.4 % of the patients were on  antihypertensive medication .  Only 37.4 % of the patients admitted to adhering to diabetic diet regularly  and 32.0 %  exercised regularly . As for glucose monitoring only 6.9 % of the patients did  home blood glucose monitoring  and 6.2 % did  home urine glucose .  There was also a high complication rate with the commonest being neuropathy ( 30.1 % ) followed by background retinopthy ( 23.5 % ) , albuminuria ( 22.9 % ) and microalbuminuria ( 20.4 % ) . In conclusion , the majority of diabetic patients treated at the primary care level were not satisfactorily controlled and this was associated with a high prevalence of complications . There is an urgent need to educate both patients and health care personnel on the importance of achieving the clinical targets and greater effort must be made to achieve these targets
The proposed EHR-based approach will quantify the T2DM severity for primary care performance management and inform the methodology for measuring severity of other primary care-managed chronic conditions .
INTRODUCTION The increasing prevalence of type 2 diabetes mellitus ( T2DM ) presents a significant burden on affected individuals and healthcare systems internationally .
There is , however , no agreed vali date d measure to infer diabetes severity from electronic health records ( EHRs ) .
We aim to quantify T2DM severity and vali date it using clinical adverse outcomes .