RT Journal Article
SR Electronic
T1 Characteristics of Diabetics with Poor Glycemic Control Who Achieve Good Control
JF The Journal of the American Board of Family Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 490
OP 496
DO 10.3122/jabfm.2008.06.070267
VO 21
IS 6
A1 Michal Shani
A1 Tomas R. Taylor
A1 Shlomo Vinker
A1 Alexander Lustman
A1 Rina Erez
A1 Asher Elhayany
A1 Amnon Lahad
YR 2008
UL http://www.jabfm.org/content/21/6/490.abstract
AB Objective: To find the characteristics of diabetics with poorly controlled diabetes that became well controlled compared with the patients with poorly controlled diabetes that remained poorly controlled.Methods: The sample included diabetic patients, aged 40 years and older, from the Central district of Clalit Health Service in Israel, with at least one HbA1c measure greater than 9.5 mg% during 2001. They were divided into 2 categories according to their HbA1c levels in 2003, well controlled (HbA1c <7.5 mg%) and poorly controlled (HbA1c >9.5 mg%). Patients with 7.5< HbA1c <9.5 in 2003 were excluded from analysis.Results: Two thousand sixty-two diabetic patients met the inclusion criteria and care was provided by one of 249 primary care physicians. Of these patients, 1232 (41.6%) had well-controlled diabetes and 1760 (58.4%) had poorly controlled diabetes in 2003. The well-controlled group had fewer patients with low socioeconomic status (30.3% vs 41.9%; P < .001) and more men (52% vs 43.8%; P < .001). The individual primary care physician was the most significant predictor of good glycemic control. Total patient costs in 2004 were 8% lower among the group with well-controlled diabetes.Conclusion: The primary care physician has an important role in the patient's chances of achieving glycemic control. Further investigation of how and why some primary care physicians achieve better diabetes control in their patients would be worthwhile.