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- Title
Quality of Care for Patients Diagnosed With Diabetes at Screening.
- Authors
Edelman, David; Olsen, Maren K.; Dudley, Tara K.; Harris, Amy C.; Oddone, Eugene Z.
- Abstract
OBJECTIVE Screening for diabetes has the potential to be an effective intervention, especially if patients have intensive treatment of their newly diagnosed diabetes and comorbid hypertension. We wished to determine the process and quality of diabetes care for patients diagnosed with diabetes by systematic screening. RESEARCH DESIGN AND METHODS —A total of 1,253 users of the Durham Veterans Affairs Medical Center aged 45-64 years who did not report having diabetes were screened for diabetes with an HbA[sub 1c] test. All subjects with an HbA[sub 1c] level ≥ 6.0% were invited for follow-up blood pressure and fasting plasma glucose (FPG) measurements. A case of unrecognized diabetes was defined as HbA[sub 1c] ≥ 7.0% or FPG ≥ 126 mg/dl. For each of the 56 patients for whom we made a new diagnosis of diabetes, we notified the patient's primary care provider of this diagnosis. One year after diagnosis, we reviewed these patients' medical records for traditional diabetes performance measures as well as blood pressure. Follow-up blood pressure was also ascertained from medical record review for all subjects with HbA[sub 1c] ≥ 6.0% who did not have diabetes. We compared blood pressure changes between patients with and without diabetes. RESULTS Among patients diagnosed with diabetes at screening, 34 of 53 (64%) had evidence of diet or medical treatment for their diabetes, 42 of 53 (79%) had HbA[sub 1c] measured within the year after diagnosis, 32 of 53 (60%) had cholesterol measured, 25 of 53 (47%) received foot examinations, 29 of 53 (55%) had eye examinations performed by an eye specialist, and 16 of 53 (30%) had any measure of urine protein. The mean blood pressure decline over the year alter diagnosis for patients with diabetes was 2.3 mmHg; this decline was similar to that found for 183 patients in the study without diabetes (change in blood pressure, -3.6 mmHg). At baseline, 48% of patients with diabetes had blood pressure < 140/90, compared with...
- Subjects
DIABETES; HYPERTENSION
- Publication
Diabetes Care, 2003, Vol 26, Issue 2, p367
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/diacare.26.2.367