[Analysis of laboratory tests in adults with diabetes in Hungary].

Abstract

Introduction: Diabetes remains a significant healthcare burden despite declining incidence. However, a systematic, nationwide assessment of the care routine is lacking. Objective: To evaluate diabetes care practice in Hungary using laboratory test completion data as reflected in available administrative data. Methods: Using administrative data from the National Health Insurance Fund (2010–2021), we performed a retrospective cohort study to analyze the completion rates of laboratory tests, as recommended by clinical guidelines, among diabetes patients in 4 cohorts over a 4-year follow-up period. Multivariate logistic regression analysis was used to identify factors associated with test completion. Results: 128,115 patients were included. Over 70% had blood glucose and serum creatinine tests in at least 3 different years over the 4-year period, while HbA1c, urinary glucose, and urinary ketone tests were performed in 50–60%. LDL-cholesterol or urinary albumin testing was <30% within the 4 years following the first antidiabetic medication initiation. Testing rates declined during the pandemic (2020–2021). Testing was less likely among men, younger age groups, and those on metformin and/or sulfonylurea only. Results showed a declining trend over time. Discussion: Our findings highlight the need for clearer roles and responsibilities in diabetes care, the provision of information technology tools, reminder systems, and sufficient capacity to facilitate laboratory testing and better patient education. Limitations include lack of access to test results, private and point-of-care testing data. Conclusions: In light of the current national clinical guidelines, an examination of relevant laboratory tests alone reveals that there are areas for improvement in the functioning of domestic diabetes care and the underlying data provision. The establishment of integrated care, the clear definition of tasks and responsibilities, the inclusion of point-of-care tests and laboratory tests results in data provision can significantly contribute to the development of diabetes care in our country. Orv Hetil. 2024; 165(52): 2047–2060.