Maxwell S Stem1, Taylor S Blachley1, Roni M Shtein1, William H Herman2, Thomas W Gardner1, Joshua D Stein3. 1. Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, USA. 2. Department of Internal Medicine, University of Michigan Medical School, USA; Department of Epidemiology, University of Michigan, USA; Institute for Healthcare Policy and Innovation, University of Michigan, USA. 3. Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, USA; Institute for Healthcare Policy and Innovation, University of Michigan, USA. Electronic address: jdstein@med.umich.edu.
Abstract
AIM: To assess how hemoglobin A1c (HbA1c) values might change following the diagnosis of the first complication from diabetes mellitus (DM). METHODS: Using a nationwide, longitudinal managed care network claims database (2001-2011), we identified patients with DM who experienced an initial diabetes-related complication. A paired t-test was used to compare average HbA1c levels before the initial complication was first diagnosed to average HbA1c levels following the diagnosis of the complication. RESULTS: 518 enrollees met study inclusion criteria. Patients with suboptimally controlled DM (defined as HbA1c>7% (53 mmol/mol)) prior to the diagnosis of their first diabetic complication demonstrated a clinically significant reduction in average HbA1c following the diagnosis of their first complication (mean pre-complication HbA1c=8.5 ± 1.5% (69 ± 17 mmol/mol) vs. mean post-complication HbA1c=7.9 ± 1.7% (63 ± 18 mmol/mol) (p<0.0001)). CONCLUSION: Enrollees with suboptimally controlled DM may achieve better glycemic control following the diagnosis of a complication from DM. The results from this study, if confirmed in prospective studies, may provide a rationale for the earlier detection of complications from DM to facilitate improved glycemic control among patients with DM.
AIM: To assess how hemoglobin A1c (HbA1c) values might change following the diagnosis of the first complication from diabetes mellitus (DM). METHODS: Using a nationwide, longitudinal managed care network claims database (2001-2011), we identified patients with DM who experienced an initial diabetes-related complication. A paired t-test was used to compare average HbA1c levels before the initial complication was first diagnosed to average HbA1c levels following the diagnosis of the complication. RESULTS: 518 enrollees met study inclusion criteria. Patients with suboptimally controlled DM (defined as HbA1c>7% (53 mmol/mol)) prior to the diagnosis of their first diabetic complication demonstrated a clinically significant reduction in average HbA1c following the diagnosis of their first complication (mean pre-complication HbA1c=8.5 ± 1.5% (69 ± 17 mmol/mol) vs. mean post-complication HbA1c=7.9 ± 1.7% (63 ± 18 mmol/mol) (p<0.0001)). CONCLUSION: Enrollees with suboptimally controlled DM may achieve better glycemic control following the diagnosis of a complication from DM. The results from this study, if confirmed in prospective studies, may provide a rationale for the earlier detection of complications from DM to facilitate improved glycemic control among patients with DM.