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Glycemic Control in Patients with Employer-Sponsored Health Benefits.
Judy Z Louie1, Charles M Rowland1, Dov Shiffman1
1Quest Diagnostics Nichols Institute, San Juan Capistrano, California, USA.
Population Health Management
|February 24, 2025
Summary
Even with health insurance, many patients with type 2 diabetes struggle with glycemic control. Poor control is linked to less physical activity and lower engagement with healthcare providers.
Area of Science:
- Endocrinology
- Public Health
- Health Services Research
Background:
- Health insurance is crucial for diabetes management, yet achieving glycemic control remains difficult for many.
- Poor glycemic control, defined as hemoglobin A1c (HbA1c) >8.5%, affects a significant portion of patients with type 2 diabetes (T2D).
Purpose of the Study:
- To identify factors associated with poor glycemic control in T2D patients with employer-sponsored health insurance.
- To understand the prevalence and persistence of poor glycemic control despite healthcare access.
Main Methods:
- Analysis of data from 2981 employees and spouses with T2D and continuous insurance coverage.
- Assessment of demographics, physical activity, healthcare provider engagement, and medical/socioeconomic factors.
- Definition of T2D using ICD codes, diagnoses, or glucose/HbA1c levels; poor control defined as HbA1c >8.5%.
Main Results:
- 16% of patients had poor glycemic control (HbA1c >8.5%), and 43% had HbA1c >7%.
- Poor glycemic control was associated with younger age, male sex, more diabetes complications, increased medication use, less physical activity, and poorer engagement with healthcare providers.
- Poor glycemic control was persistent, with 76% having poor control in at least one of the previous three years.
Conclusions:
- Glycemic control remains a significant challenge for T2D patients even with employer-sponsored health insurance.
- Improving physical activity and enhancing patient-provider engagement are potential strategies to improve glycemic control in this population.
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