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Characteristics of diabetics with poor glycemic control who achieve good control

Michal Shani1, Tomas R Taylor, Shlomo Vinker

  • 1Department of Family Medicine, Central District, Clalit Health Service, Rehovot, Israel. michal.shani@gmail.com

Journal of the American Board of Family Medicine : JABFM
|November 8, 2008
PubMed

Insights

Primary care physicians significantly impact diabetes management. Achieving well-controlled diabetes is linked to factors like socioeconomic status, physician influence, and lower healthcare costs.

Area of Science:

  • Endocrinology
  • Primary Care Medicine
  • Health Services Research

Background:

  • Poorly controlled diabetes poses significant health risks and increases healthcare costs.
  • Identifying factors associated with improved glycemic control is crucial for effective diabetes management.
  • Previous research highlights patient-level factors, but the role of primary care physicians (PCPs) warrants further investigation.

Purpose of the Study:

  • To characterize diabetic patients who transitioned from poorly controlled to well-controlled diabetes.
  • To compare these patients with those who remained poorly controlled.
  • To identify predictors of successful glycemic control in a primary care setting.

Main Methods:

  • Retrospective cohort study of diabetic patients aged 40+ from Clalit Health Service in Israel (2001-2003).
  • Inclusion criteria: HbA1c >9.5 mg% in 2001.
  • Categorization in 2003: Well-controlled (HbA1c <7.5 mg%) vs. Poorly controlled (HbA1c >9.5 mg%).

Main Results:

  • 2062 patients met criteria; 41.6% achieved well-controlled diabetes in 2003.
  • Well-controlled group had lower socioeconomic status (30.3% vs 41.9%) and higher male proportion (52% vs 43.8%).
  • Individual PCP was the strongest predictor of glycemic control; well-controlled patients had 8% lower total costs in 2004.

Conclusions:

  • The PCP plays a pivotal role in achieving glycemic control for diabetic patients.
  • Understanding the mechanisms by which certain PCPs achieve better outcomes is essential.
  • Further research should explore effective primary care strategies for diabetes management.
Abstract

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