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HbA1c levels lower among patients who provided home glucose data in the clinic
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SAN FRANCISCO — Data from a chart review of patients with diabetes revealed that only a small number of patients share reliable self-monitoring of blood glucose data with their providers during appointments. According to researchers, this information could help determine which patients would benefit most from reminders to bring their data to the clinic.
“Only a minority of patients (approximately 30%) actually bring glucose meters to their provider visits,” Gillian Boyd-Woschinko, MD, chief endocrine fellow at Mount Sinai, told Endocrine Today. “Of Medicaid and Medicare patients with uncontrolled diabetes, those who brought their glucose meters to appointments had a significant drop in their HbA1c (1.2%), compared to those who did not.”
Ronald Tamler
Boyd-Woschinko and colleagues, including Endocrine Today Editorial Board member Ronald Tamler, MD, MBA, reviewed the charts of 500 patients with type 2 diabetes seen either in an Endocrinology Faculty/Commercial Insurance Practice (FP; n=285) or a Managed Medicare/Medicaid Diabetes Clinic (MDC; n=215) from January 1, 2012 to June 30, 2012. The researchers looked at anthropometric data, HbA1c, change in HbA1c from the previous visit and availability of reliable self-monitoring of blood glucose (r-SMBG) data at the time of the visit.
More than half of patients included in the sample were female (59.4%), 36% were Hispanic, 30% were black and 21% were white. Ten percent of patients had type 1 diabetes. Insulin was used among 67% of patients and oral hypoglycemic medication was used in 32%.
Thirty percent of patients brought r-SMBG data to their appointment, and researchers observed no difference between patients in the MDC group vs. those in the FP group. Of patients with r-SMBG data in the MDC group, 91% were using insulin and 30% of patients in the FP group were treated only with oral medication.
Among those in the MDC group, mean HbA1c was 9.1% vs. 7.9% among those in the FP group (P<.001). Change in A1c from the previous visit among patients in the MDC group with r-SMBG data was –1.2% vs. +0.1% among those in the MDC group who did not provide r-SMBG data (P=.05). There was no change in HbA1c from the previous visit among FP patients who provided r-SMBG data.
“Our findings support the importance of communicating reliable glucose data with providers and help us focus our resources toward the patient population who will most benefit from this behavior,” she said. – by Stacey L. Adams
For more information:
Boyd-Woschinko G. #SUN-812. Presented at: The Endocrine Society Annual Meeting and Expo; June 15-18, 2013; San Francisco.
Disclosure: Boyd-Woschinko reports no relevant financial disclosures.