Analysis of a primary care led diabetes annual review programme in a multi ethnic cohort in Wellington, New Zealand

IntroductionIn 2000 a primary care led “Get Checked” programme of free annual diabetes reviews was introduced in New Zealand. This report explores changes in clinical variables over five annual visits in relation to ethnicity.MethodsFrom 19,054 people in the Wellington region all 2967 with Type 2 diabetes completing five visits between 2000 and 2006 contributed data. This included weight, blood pressure, HbA1c, lipids, and urinary albumin:creatinine ratio. Mixed linear models examined changes in clinical variables by visit and the relationships with ethnicity.ResultsOf the 2967, 69.5% were European, 10.0% Maori, 8.6% Pacific and 10.4% Asian. Weight, systolic and diastolic blood pressure declined. HbA1c initially declined with time in Maori, Pacific and Asian and then rose. Total cholesterol decreased and HDL cholesterol rose. Urinary albumin:creatinine ratio fell at first and then rose and the degree of change was dependent on ethnicity. Use of diabetes medications and ACE inhibitor prescription increased in all ethnicities. Statin prescriptions rose from 20 to 61%. Current smoking rates fell from 10.7% to 9.4%.ConclusionThis programme showed improvements in intermediate outcomes of diabetes care across all ethnic groups highlighting the benefit of reducing barriers to, and increasing engagement with, good primary health care.