EPIDEMIOLOGY IN MALTA FROM ROUTINE HEALTH INFORMATION

Objective: To estimate the prevalence of diabetes in the Maltese Islan ds from data regarding drug consumption, and to assess the prescribing habits and management attitudes of local doctors. Methodology: The pr escribed average daily dose of each type of anti-diabetic drug was cal culated from random representative samples of patients (total 1,444) a ttending the Health Department's primary and secondary health centres as well as of patients seeing their private practitioners. This consti tuted circa 16% of the total estimated number of diabetics on drug the rapy in Malta. The quantities of drugs consumed were obtained both fro m Government and private industry sources, whilst relevant data on the rapy modalities, including proportions of patients on st combination o f anti-diabetic preparations, were obtained from records held at the D ept. of Health. Results: Applying the appropriate formulae (as propose d by Eurodiab. subarea C 1989 programme) the global prevalence of diab etes worked out to be 5.22%, an underestimate of circa 12% of the figu re extrapolated from the recent population based epidemiological studi es. Overall 51% of cases were treated with 'diet only', whilst less th an 10% of subjects were managed with insulin. Compared to patients att ending the better staffed and equipped health centres, those seeing th eir private physicians were proportionately less frequently put on ins ulin (5.7% vs 11.7%), and were prescribed a slightly higher mean daily dose (1.7 vs. 1.4 tab) of glibenclamide suggesting the need of better education of the patient (and probably also of the physician). Conclu sion: This type of study proved to be relatively simple and inexpensiv e to perform. Although it cannot replace epidemiological field surveys it can still give a reasonably fair (albeit with limitations) estimat e of diabetes prevalence in a population. Moreover it permits an impor tant insight into local public health indicating ways to improve diabe tes care.