Controlling the ABCs of diabetes in clinical practice: a community-based endocrinology practice experience

Determine A1C, blood pressure (BP), and total cholesterol (TC) (Diabetes ABCs) control in a community-based endocrinology practice (CBEP) and compare levels to national averages. Additionally, determine patient factors associated with ABC control.

A retrospective chart audit of 395 consecutive patients seen for diabetes management was conducted for years 2000-2004 to examine levels of control of the ABCs. Multivariate models were used to determine patient factors associated with control.

Significantly more patients met the goal of A1C <7% in the CBEP compared to national estimates (CBEP: 47.1% vs. NHANES 1999-2000: 37%, p=0.003). Similar patterns were observed for BP (CBEP: 53.2% vs. NHANES 1999-2000: 35.8%, p<0.0001), TC (CBEP: 82% vs. NHANES 1999-2000: 48.2%, p<0.0001), and all three ABCs (CBEP: 22%, vs. NHANES 1999-2000: 7.3%, p<0.0001). The proportion of patients meeting all three ABC goals in the CBEP increased significantly over time (p<0.0001). Multivariate models demonstrated that patients not needing insulin (p<0.0001), and taking fewer BP (p<0.0001), and cholesterol-lowering medications (p<0.02) were significantly more likely to have ABCs in control.

Attainment of ABC goals is feasible in a CBEP and can be achieved at rates higher than national averages. Attention to factors that affect these goals is warranted.