OBJECTIVE: To determine whether patients with diabetes under follow-up surveillance in a subspecialty clinic are receiving care that meets the guidelines recommended by the American Diabetes Association and American Association of Clinical Endocrinologists. METHODS: We abstracted 2 years of medical records of patients sampled from 2 academic diabetes clinics, managed by board-certified endocrinologists. Information regarding the testing for and results of hemoglobin A1c (A1C), lipids, blood pressure, and microalbuminuria was recorded and analyzed. RESULTS: The data on 499 patients were analyzed. More than 90% of patients had the recommended A1C, lipid, and blood pressure testing. Approximately 25% of patients had A1C levels >7%, and about 14% had A1C levels >6.5%. Total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels were at target in approximately 82%, 65%, and 68% of patients, respectively. Approximately 55% of male and 50% of female patients had high-density lipoprotein cholesterol levels at target. Blood pressure was controlled in approximately a third of the patients. Approximately 30% of patients tested had microalbuminuria. Only 6.8% of patients in year 1 and 3.5% of patients in year 2 had all these risk factors (A1C, lipids, and blood pressure) at target levels. CONCLUSION: The results indicate that in our subspecialty clinics, although testing for "risk factors" is being done at a high frequency, the targets for these risk factors are being met by only a limited number of patients. We believe that this result may be due to patient- or system-related factors but not due to physician knowledge. Therefore, emphasis should be placed on patient and system factors to improve the outcomes of the care of patients with diabetes.
OBJECTIVE: To determine whether patients with diabetes under follow-up surveillance in a subspecialty clinic are receiving care that meets the guidelines recommended by the American Diabetes Association and American Association of Clinical Endocrinologists. METHODS: We abstracted 2 years of medical records of patients sampled from 2 academic diabetes clinics, managed by board-certified endocrinologists. Information regarding the testing for and results of hemoglobin A1c (A1C), lipids, blood pressure, and microalbuminuria was recorded and analyzed. RESULTS: The data on 499 patients were analyzed. More than 90% of patients had the recommended A1C, lipid, and blood pressure testing. Approximately 25% of patients had A1C levels >7%, and about 14% had A1C levels >6.5%. Total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels were at target in approximately 82%, 65%, and 68% of patients, respectively. Approximately 55% of male and 50% of female patients had high-density lipoprotein cholesterol levels at target. Blood pressure was controlled in approximately a third of the patients. Approximately 30% of patients tested had microalbuminuria. Only 6.8% of patients in year 1 and 3.5% of patients in year 2 had all these risk factors (A1C, lipids, and blood pressure) at target levels. CONCLUSION: The results indicate that in our subspecialty clinics, although testing for "risk factors" is being done at a high frequency, the targets for these risk factors are being met by only a limited number of patients. We believe that this result may be due to patient- or system-related factors but not due to physician knowledge. Therefore, emphasis should be placed on patient and system factors to improve the outcomes of the care of patients with diabetes.
Authors: Sanjeev N Mehta; Allison B Goldfine; Martin J Abrahamson; William McMullen; Lori M B Laffel Journal: Endocr Pract Date: 2016-01-27 Impact factor: 3.443
Authors: Andrew E Uloko; Esther N Ofoegbu; Sunday Chinenye; Olufemi A Fasanmade; Adesoji A Fasanmade; Anthonia O Ogbera; Osi-Ogbu Ogbu; Johnnie M Oli; Bakari A Girei; Abdullahi Adamu Journal: Indian J Endocrinol Metab Date: 2012-07
Authors: Deepika Shrestha; Sally Picciotto; Michael P LaValley; Sa Liu; S Katharine Hammond; Daniel E Weiner; Ellen A Eisen; Katie M Applebaum Journal: Occup Environ Med Date: 2021-07-01 Impact factor: 4.948