European Primary Care Cardiovascular Society

Room for improvement of diabetes care in the Netherlands

Trends in mortality, cardiovascular complications, and risk factors in type 2 diabetes

Literature - Heintjes EM, Houben E, Beekman-Hendriks WI, et al. - Neth J Med. 2019 Dec;77(9):317-329

Introduction and methods

In the Euro Diabetes Index 2014, the quality of T2DM care in the Netherlands took the second place due to its primary care programs that are well organized (regular check-ups in a multidisciplinary team) [1]. General practitioners (GP)s are the primary treating physicians who treat T2DM patients in the Netherlands. Main criticism by the Euro Diabetes Index 2014 of Dutch diabetes care was the lack of data on CV outcomes.

It is unclear whether changes have occurred in diabetes care and how this has affected outcomes in T2DM patients in the Netherlands. Trends in CV incidence and mortality in T2DM patients compared to diabetes-free individuals between 2008 and 2016 were examined, as well as trends in proportion reaching target goals of risk factors and changes in use of glucose-lowering drugs.

Data were obtained from the PHARMO Database Network. This network links out-patient pharmacy drug dispensing, laboratory test results from primary and secondary care, primary care GP records, secondary care hospitalizations, and mortality records. Also hospitalization data from the Dutch Hospital Data Foundation [2] was used for accurate dates of CV events. Annual cohorts of T2DM patients with index dates of January 1 of each year were identified between 2008 and 2016. Patients free of diabetes were matched controls to create matched annual cohorts (matching based on age, sex and treating GP).

Main results


An analysis of data from the PHARMO Database Network showed that although diabetes care is well organized in the Netherlands, rates for CV events and mortality did not decrease over the study period from 2008 to 2016. Life years lost due to T2DM is 3.5 years at the age of 55 years and in addition with CVD there is an additional loss of 1.5 years. These findings suggest there is room for improvement of management of T2DM patients to obtain better outcomes.


Show references

Find this article online at Neth J Med

Share this page with your colleagues and friends: