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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)

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.
Diabetes care 2010 v.33 no.12 pp. 2558-2560
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
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.