Temporal HbA1c patterns amongst patients with type 2 diabetes referred for specialist care: Data from the S4S-DINGO-Diabetes Informatics Group
AIMS: To evaluate the achievement of HbA1c targets in patients with type 2 diabetes mellitus in specialist practice. METHODS: This audit was undertaken by members of the S4S Diabetes Informatics Group (DINGO), a consortium of Australian endocrinologists in private practice who contribute de-identified data from their electronic medical record, Audit 4 (Software 4 Specialists, S4S, Australia & New Zealand) for audit purposes. Data from patients with type 2 diabetes was extracted. Inclusion criteria were: initial age<70years, baseline HbA1c>7% (53mmol/mol), with at least another HbA1c recorded in the next 2years, and a minimum of 2years follow-up. Data was analysed using a linear mixed effects model. RESULTS: Of the 4796 patients in the dataset with type 2 diabetes mellitus, 1379 patients fulfilled inclusion criteria. The median age at initial consultation was 57 (49-64)years. The median baseline HbA1c was 8.7 (7.8-9.8)% (72mmol/mol). There was a 1.0% reduction in HbA1c to 7.7 (7.1-8.6)% (61mmol/mol) (p<0.0001) in the first 3-6months following referral, after which there were no further changes. The initial reduction was maintained with minimal loss of control at 4years. By 3-6months, 24% of patients achieved the target HbA1c. CONCLUSIONS: Referral of patients with type 2 diabetes to an endocrinologist reduces HbA1c, and the effect is sustained over the medium term; however only a minority of patients reach targets.
|ISBN||1872-8227 (Electronic) 0168-8227 (Linking)|
|Authors||Lam, T.; Hoffman, D. M.; Cukier, K.; Darnell, D.; Greenfield, J. R.; Harrison, N.; Hng, T. M.; Morrow, A. F.; Cheung, N. W.;|
|Publisher Name||DIABETES RESEARCH AND CLINICAL PRACTICE|
|URL link to publisher's version||http://www.ncbi.nlm.nih.gov/pubmed/27321331|
|OpenAccess link to author's accepted manuscript version||https://publications.gimr.garvan.org.au/open-access/13647|