[CROATIAN GUIDELINES FOR THE PHARMACOTHERAPY OF TYPE 2 DIABETES]. / HRVATSKE SMJERNICE ZA FARMAKOLOSKO LIJECENJE SECERNE BOLESTI TIPA 2.

INTRODUCTION: The Croatian Association for Diabetes and Metabolic Disorders of the Croatian Medical Association has issued in 2011 the first national guidelines for the nutrition, education, self-control, and pharmacotherapy of diabetes type 2. According to the increased number of available medicines and new evidence related to the effectiveness and safety of medicines already involved in the therapy there was a need for update of the existing guidelines for the pharmacotherapy of type 2 diabetes in the Republic of Croatia. PARTICIPANTS: as co-authors of the Guidelines there are listed all members of the Croatian Association for Diabetes and Metabolic Diseases, as well as other representatives of professional societies within the Croatian Medical Association, who have contributed with comments and suggestions to the development of the Guidelines. EVIDENCE: These guidelines are evidence-based, according to the GRADE system (eng. Grading of Recommendations, Assessment, Development and Evaluation), which describes the level of evidence and strength of recommendations. CONCLUSIONS: An individual patient approach based on physiological principles in blood glucose control is essential for diabetes' patients management. Glycemic targets and selection of the pharmacological agents should be tailored to the patient, taking into account the age, duration of disease, life expectancy, risk of hypoglyce- mia, comorbidities, developed vascular and other complications as well as other factors. Because of all this, is of national interest to have a practical, rational and applicable guidelines for the pharmacotherapy of type 2 diabetes.

Organizational structure of the Croatian family practice: a longitudinal study based on routinely collected data.

This study was undertaken with the main aim of determining the trends in the number of family doctors' (FD), gender and educational structure, working status and the number of patients per FD between 1995 and 2013. As the main source of data collection served the Croatian Health Service Yearbooks and Croatian Health Insurance Fund (CHIF) databases on practices and FDs contracting in 2013. Obtained results indicated that the number of contracted FDs increased until 2007, then decreased, and again increased until 2350 in 2013. Average number of patients on FDs list was 1987 in 2012. Less than 50% FDs were specialist in family medicine, 70.3% of them were self-employed with the CHIF contract, and 81% were women. 123 practices planned by the Network did not have contracting FD in 2013. The lack of FDs, the huge number of patients over the standard number, and the location of the missing practices within the rural communities, together make Croatian FM practices less accessible.

[CroDiab GP--follow up of diabetics protection in general medicine]. / CroDiab GP--pracenje zastite dijabetickih bolesnika u obiteljskoj medicini.

INTRODUCTION: There is an increasing number of diabetics in the population. Care of diabetes mellitus type 2 has been transferred from specialist care to the level of general practice. Collecting data and making database of diabetic care are set as quality indicators of diabetic care. AIM: The aim is to present the electronic CroDiab GP program as a tool for collecting data on diabetics in family practice in Croatia. Another aim is to track diabetic quality care and include patients in the national registry of diabetics. METHODS: The program was demonstrated on a sample of 10 family practice units with approximately 18,000 patients from four districts in north Croatia. These units are involved in the project of tracking diabetic care quality in family medicine. The core population for data collection is set by the basic diagnostic unit according to ICD-10: E10-E14. The program mainframe is the CroDiab NET computer system. The central module of CroDiab NET is BIS (Basic Information Sheet). It is set as optimal data collection that allows tracking diabetic care quality. Sixteen diabetic variables were analyzed. These variables refer to the type of disease, duration, treatment, and procedure for early detection of complications. RESULTS: In the population of 18,0000 patients there were 822 (4.6%) diabetics. There were 6.3% of patients with type 1 diabetes and 87.4% with type 2 diabetes; 6.3% were unknown. There were 16.0% diabetics on diet therapy, 60.7% on oral medication (1 to 3 medications), and 13.4% on insulin therapy, 8.4 diabetics were on both insulin and oral medication. CONCLUSION: Family medicine should present parameters of the quality of diabetic care. It is possible to collect data in electronic media, make statistical analysis and present data. The next step is entering patient data in the national registry of diabetics.