Liane J Tinsley1, Nathan D Wong2, Jane E B Reusch3, Suzanne V Arnold4, Mikhail N Kosiborod4, Yuanyuan Tang5, Lori M Laffel6, Sanjeev N Mehta7. 1. Clinical, Behavioral, and Outcomes Research Section, Joslin Diabetes Center, Boston, MA, USA. Electronic address: liane.tinsley@joslin.harvard.edu. 2. Division of Cardiology, University of California Irvine, Irvine, CA, USA. Electronic address: ndwong@uci.edu. 3. Endocrinology, Metabolism and Diabetes, University of Colorado, Aurora, CO, USA. Electronic address: jane.reusch@ucdenver.edu. 4. Saint Luke's Mid America Heart Institute, Kansas City, MO, USA. 5. Saint Luke's Mid America Heart Institute, Kansas City, MO, USA. Electronic address: ytang@saint-lukes.org. 6. Clinical, Behavioral, and Outcomes Research Section, Joslin Diabetes Center, Boston, MA, USA. Electronic address: lori.laffel@joslin.harvard.edu. 7. Clinical, Behavioral, and Outcomes Research Section, Joslin Diabetes Center, Boston, MA, USA. Electronic address: sanjeev.mehta@joslin.harvard.edu.
Abstract
AIMS: To compare cardiovascular risk factor control in adults with diabetes participating in a national diabetes registry to those in the general population and to ascertain regional differences in diabetes care. METHODS: Adults with diagnosed diabetes in the Diabetes Collaborative Registry (DCR) were compared with those in the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2016; standardized mean difference (SMD) > 0.2 defined significance. Regional differences were assessed in the DCR cohort; p < .05 defined significance. RESULTS: The DCR cohort was older (61 vs. 57 years, SMD = 0.38), more insured (99.7% vs. 91.0%, SMD = 0.42), and less ethnically diverse (83% non-Hispanic white vs. 76%, SMD = 0.30) compared with NHANES. The proportion of overweight/obesity, A1c < 7% (<53 mmol/mol), and BP < 140/90 were similar, but DCR participants had higher proportion with LDL < 2.59 mmol/L (61% vs. 41%, SMD = 0.39) and fewer tobacco users (17% vs. 32%, SMD = 0.35). Regionally, obesity, lack of glycaemic control, and tobacco use were highest in the Midwest, BP control was the lowest in the South, and LDL control was lowest in the Northeast. CONCLUSIONS: Significant regional differences in diabetes care delivery and outcomes were identified using a national diabetes registry. Serial analyses of the DCR may supplement national evaluations to deepen our understanding of diabetes care in the US.
AIMS: To compare cardiovascular risk factor control in adults with diabetes participating in a national diabetes registry to those in the general population and to ascertain regional differences in diabetes care. METHODS: Adults with diagnosed diabetes in the Diabetes Collaborative Registry (DCR) were compared with those in the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2016; standardized mean difference (SMD) > 0.2 defined significance. Regional differences were assessed in the DCR cohort; p < .05 defined significance. RESULTS: The DCR cohort was older (61 vs. 57 years, SMD = 0.38), more insured (99.7% vs. 91.0%, SMD = 0.42), and less ethnically diverse (83% non-Hispanic white vs. 76%, SMD = 0.30) compared with NHANES. The proportion of overweight/obesity, A1c < 7% (<53 mmol/mol), and BP < 140/90 were similar, but DCRparticipants had higher proportion with LDL < 2.59 mmol/L (61% vs. 41%, SMD = 0.39) and fewer tobacco users (17% vs. 32%, SMD = 0.35). Regionally, obesity, lack of glycaemic control, and tobacco use were highest in the Midwest, BP control was the lowest in the South, and LDL control was lowest in the Northeast. CONCLUSIONS: Significant regional differences in diabetes care delivery and outcomes were identified using a national diabetes registry. Serial analyses of the DCR may supplement national evaluations to deepen our understanding of diabetes care in the US.
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