Comprehensive risk assessments of diabetic patients from seven Asian countries: The Joint Asia Diabetes Evaluation (JADE) program

• Published in: Journal of diabetes Vol. 3; no. 2; pp. 109 - 118
• Main Authors: SO, Wing-Yee, RABOCA, Josephine, SOBREPENA, Leorino, YOON, Kun-Ho, DEEROCHANAWONG, Chaicharn, HO, Low-Tone, HIMATHONGKAM, Thep, TONG, Peter, LYUBOMIRSKY, Greg, KO, Gary, NAN, Hairong, CHAN, Juliana
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-06-2011
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Asia; Asia - epidemiology; care models; Cohort Studies; diabetes; Diabetes Complications - diagnosis; Diabetes Complications - epidemiology; Diabetes Complications - therapy; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - therapy; disease management; Female; Humans; Internet; Male; Middle Aged; quality of care; Registries; risk assessment; Risk Factors; Urban Population; Young Adult; Asia
• ISSN: 1753-0393; 1753-0407
• DOI: 10.1111/j.1753-0407.2011.00115.x

Background:  The aim of the web‐based Joint Asia Diabetes Evaluation (JADE) program is to establish a registry for quality assurance, monitoring, and evaluation.
Methods:  The JADE electronic portal provides templates for data collection, supplemented by risk stratification, care protocols, and decision support. Herein, data from 3687 patients with Type 2 diabetes, enrolled over 15 months in 2007–2009 from seven Asian countries, are reported.
Results:  Of the patients, 46.1% were men, the median (range) age was 58 (15–93 years), and median disease duration was 6.5 (0–71) years; 16.2% had at least one cardiovascular–renal complication (10.0% coronary heart disease, 3.3% stroke, 3.1% peripheral vascular disease, 0.4% end‐stage renal disease), 20.4% had diabetic retinopathy, 15.0% had sensory neuropathy, 7.5% had chronic kidney disease, and 20.7% of men had erectile dysfunction. Hypertension, dyslipidemia, and central obesity affected 84.6%, 76.8%, and 53.5% of patients, respectively. Treatment targets were HbA1c <7% in 35.3%, blood pressure <130/80 mmHg in 32.3%, and low‐density lipoprotein–cholesterol <2.6 mmol/L in 34.0%. The rate of attaining one, two, and three targets was 38.7%, 23.4%, and 5.4%, respectively. Using the JADE Risk Engine, 60% of patients with clinical complications and 20% of those with multiple risk parameters were predicted to have a major event within 5 years. Older age, short disease duration, adherence to diet, control of other risk factors, and not smoking were independently associated with HbA1c <7% (all P < 0.05).
Conclusions:  It is possible to use a web‐based protocol to establish a registry for risk stratification and facilitate early intervention.