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).

Abstract

OBJECTIVE:

To identify factors in patients with type 2 diabetes and A1C >7.0% associated with attainment of A1C ≤ 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 ≤ 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 ≤ 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.

• Authors: Hwee Teoh, Manoela F B Braga, Amparo Casanova, Denis Drouin, Shaun G Goodman, Stewart B Harris, Anatoly Langer, Mary K Tan, Ehud Ur, Andrew T Yan, Bernard Zinman, Lawrence A Leiter, T2DM QUERI Investigators
• Journal: Diabetes care (Diabetes Care) Vol. 33 Issue 12 Pg. 2558-60 (Dec 2010) ISSN: 1935-5548 [Electronic] United States
• PMID: 20823344 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin Receptor Antagonists
• Blood Glucose
• Glycated Hemoglobin A
• Hypoglycemic Agents

Topics

• Angiotensin Receptor Antagonists (therapeutic use)
• Blood Glucose (drug effects)
• Blood Pressure (drug effects)
• Diabetes Mellitus, Type 2 (drug therapy, ethnology, metabolism, pathology)
• Female
• Glycated Hemoglobin (metabolism)
• Humans
• Hypoglycemic Agents (therapeutic use)
• Insurance Coverage
• Insurance, Pharmaceutical Services
• Male
• Middle Aged
• Risk Factors