Type 2 diabetes specialist care in Italy in the AMD Annals initiative 2024: The path is traced

Aims: The AMD Annals initiative, active in Italy since 2006, monitors diabetes care quality, showing continuous improvements through standardized indicators. This report presents the 2024 data on type 2 diabetes (T2D). Methods: Approximately half of the Italian diabetes centers annually extract anonymized electronic medical records data. Process, treatment and outcome indicators, and the Q-score, a validated score of overall care, were evaluated. Results: Data from 301 centers on 680,122 T2D patients (58.6 % men, mean age 69.9 years; 35.9 % > 75 years) were evaluated. HbA1c ≤ 7.0 % was achieved by 55.9 % of patients, LDL < 70 mg/dl by 44.6 %, blood pressure (BP) < 130/80 mmHg by 26.5 %, with 7.7 % meeting multiple targets. Obesity showed a prevalence of 35 %, while smoking was high (17.9 %). Pharmacological treatment improved: 72.0 % used lipid-lowering drugs, 68.8 % BP-lowering, and 97.6 % glucose-lowering drugs. As for innovative drugs, 41.9 % of patients were treated with SGLT2i and 35.5 % with GLP1 RA, with an increasing trend compared to 2023 data. Complication rates remained stable, with a further Q-score improvement. Conclusions: The 2024 data confirm ongoing improvements in T2D care, despite an aging population. Although gaps persist, the path toward aligning practice with guidelines is well established.