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Patient Age, Ethnicity, Medical History, and Risk Factor Profile, but Not Drug Insurance Coverage, Predict Successful Attainment of Glycemic Targets: Time 2 Do More Quality Enhancement Research Initiative (T2DM QUERI)

Author:
Teoh, Hwee, Braga, Manoela F.B., Casanova, Amparo, Drouin, Denis, Goodman, Shaun G., Harris, Stewart B., Langer, Anatoly, Tan, Mary K., Ur, Ehud, Yan, Andrew T., Zinman, Bernard, Leiter, Lawrence A.
Source:
Diabetes care 2010 v.33 no.12 pp. 2558-2560
ISSN:
0149-5992
Subject:
blood pressure, body mass index, demography, drugs, glycemic effect, guidelines, insurance, low density lipoprotein cholesterol, medical history, nationalities and ethnic groups, noninsulin-dependent diabetes mellitus, patients, risk factors
Abstract:
OBJECTIVE: To identify factors in patients with type 2 diabetes and A1C >7.0% associated with attainment of A1C [less-than or equal to]7.0%. RESEARCH DESIGN AND METHODS: We used a prospective registry of 5,280 Canadian patients in primary care settings enrolled in a 12-month glycemic pharmacotherapy optimization strategy based on national guidelines. RESULTS: At close out, median A1C was 7.1% (vs. 7.8% at baseline) with 48% of subjects achieving A1C [less-than or equal to]7.0% (P < 0.0001). Older patients of Asian or black origin, those with longer diabetes duration, those with lower baseline A1C, BMI, LDL cholesterol, and blood pressure, and those on angiotensin receptor blockers and a lower number of antihyperglycemic agents, were more likely to achieve A1C [less-than or equal to]7.0% at some point during the study (all P < 0.0235). Access to private versus public drug coverage did not impact glycemic target realization. CONCLUSIONS: Patient demography, cardiometabolic health, and ongoing pharmacotherapy, but not access to private drug insurance coverage, contribute to the care gap in type 2 diabetes.
Agid:
288273