The Singapore National Healthcare Group Diabetes Registry - Descriptive Epidemiology of Type 2 Diabetes Mellitus

Introduction: The National Healthcare Group (NHG) launched an enterprise-wide diabetes registry in 2007. We describe the epidemiology of type 2 diabetes mellitus from 2005 to 2008. Materials and Methods: Patients with encounters in NHG from 2005 were identified for inclusion into the Diabetes Registry from existing stand-alone diabetes registries, ICD9CM diagnosis codes, anti-hyperglycaemic medication and laboratory confirmation. Variables extracted for analysis were demographics (age, gender, ethnicity), diabetes-related comorbidities and complications, most recent anti-hyperglycaemic agents dispensed, and the most recent glycated haemoglobin (HbA1C) measurement. Results: The diabetes registry grew 32% from 129,183 patients in 2005 to 170,513 patients in 2008, making up 12% to 15% of all patients in NHG. About half of the type 2 diabetes patients were aged 45 to 64 years. Females were generally older with a median age of 63 to 64 years vs 59 to 61 years in males. The Indian ethnic group accounted a disproportionately higher 13% of patients. Over 95% of type 2 patients had at least one diabetes-related comorbid condition, and diabetes-related complications were principally renal and cardiovascular complications. The majority (86.2% to 89.2%) of primary care patients were on oral anti-hyperglycaemic agents; however, the rate of insulin treatment increased from 10.8% to 13.8%. HbAlC levels in 2008 improved over that in 2005, with the percentage of patients with good glycaemic control improving with age. Conclusion: The registry has enabled a baseline assessment of the burden and the care of type 2 diabetes patients in NHG, which will provide critical "evidence" for planning future programmes.