Original Article
Gillian S. Boyd-Woschinko, MD1; David L. Kaiser, BS1; Michael Diefenbach, PhD2; Ronald Tamler MD, PhD1 ABSTRACT Objective: To establish the prevalence of reliable selfmonitored blood glucose (r-SMBG) data at office visits for diabetes and to determine whether r-SMBG is associated with changes in glycemic control and other clinical parameters. Methods: We conducted a chart review of 500 patients followed in an Endocrinology Faculty/Commercial Insurance Practice (FP) or a Managed Medicare/Medicaid Diabetes Clinic (MDC). Follow-up visits for patients with type 1 or type 2 diabetes from January 1, 2012 to June 30, 2012 were analyzed for anthropometric data, creatinine (Cr), glomerular filtration rate (GFR), low-density lipoprotein cholesterol (LDL-C), medications, hemoglobin A1C (A1C), change in A1C from the previous visit (∆A1C), and availability of r-SMBG data at the visit. Results: Our sample was composed of 215 MDC patients (43%) and 285 FP patients (57%). Overall, 151 patients (30%) provided r-SMBG data at their visit, with no difference between MDC or FP patients. Mean A1C at MDC was 9.1%, while mean A1C at FP was 7.9% (P8.0% demonstrated an A1C reduction of 1.2% if they provided r-SMBG, compared to
Submitted for publication July 1, 2013 Accepted for publication October 7, 2013 From: 1The Hilda and J. Lester Gabrilove Division of Endocrinology, Diabetes, and Bone Disease, Department of Medicine, The Mount Sinai Hospital, New York, New York, 2Department of Urology, The Mount Sinai Hospital, New York, New York. Address correspondence to Dr. Ronald Tamler, 1 Gustave L. Levy Place, Box #1055, New York, NY 10029. E-mail: [email protected]. Published as a Rapid Electronic Article in Press at http://www.endocrine practice.org on November 18, 2013. DOI:10.4158/EP13293.OR To purchase reprints of this article, please visit: www.aace.com/reprints. Copyright © 2014 AACE.
an increase of 0.1% for MDC patients who did not (P130 mm Hg and diastolic blood pressure (DBP) >80 mm Hg based on best practices at the time of the study (14). Patients were defined as having diabetic retinopathy by self-report or documented exam from an ophthalmologist if available in the chart. Diabetic neuropathy was attributed to patients with decreased lower extremity sensation on physical exam or self-reported bilateral numbness or parasthesias. Diabetic nephropathy was defined by serum Cr concentration above the upper limit of normal or GFR
Gillian S. Boyd-Woschinko, MD1; David L. Kaiser, BS1; Michael Diefenbach, PhD2; Ronald Tamler MD, PhD1 ABSTRACT Objective: To establish the prevalence of reliable selfmonitored blood glucose (r-SMBG) data at office visits for diabetes and to determine whether r-SMBG is associated with changes in glycemic control and other clinical parameters. Methods: We conducted a chart review of 500 patients followed in an Endocrinology Faculty/Commercial Insurance Practice (FP) or a Managed Medicare/Medicaid Diabetes Clinic (MDC). Follow-up visits for patients with type 1 or type 2 diabetes from January 1, 2012 to June 30, 2012 were analyzed for anthropometric data, creatinine (Cr), glomerular filtration rate (GFR), low-density lipoprotein cholesterol (LDL-C), medications, hemoglobin A1C (A1C), change in A1C from the previous visit (∆A1C), and availability of r-SMBG data at the visit. Results: Our sample was composed of 215 MDC patients (43%) and 285 FP patients (57%). Overall, 151 patients (30%) provided r-SMBG data at their visit, with no difference between MDC or FP patients. Mean A1C at MDC was 9.1%, while mean A1C at FP was 7.9% (P8.0% demonstrated an A1C reduction of 1.2% if they provided r-SMBG, compared to
Submitted for publication July 1, 2013 Accepted for publication October 7, 2013 From: 1The Hilda and J. Lester Gabrilove Division of Endocrinology, Diabetes, and Bone Disease, Department of Medicine, The Mount Sinai Hospital, New York, New York, 2Department of Urology, The Mount Sinai Hospital, New York, New York. Address correspondence to Dr. Ronald Tamler, 1 Gustave L. Levy Place, Box #1055, New York, NY 10029. E-mail: [email protected]. Published as a Rapid Electronic Article in Press at http://www.endocrine practice.org on November 18, 2013. DOI:10.4158/EP13293.OR To purchase reprints of this article, please visit: www.aace.com/reprints. Copyright © 2014 AACE.
an increase of 0.1% for MDC patients who did not (P130 mm Hg and diastolic blood pressure (DBP) >80 mm Hg based on best practices at the time of the study (14). Patients were defined as having diabetic retinopathy by self-report or documented exam from an ophthalmologist if available in the chart. Diabetic neuropathy was attributed to patients with decreased lower extremity sensation on physical exam or self-reported bilateral numbness or parasthesias. Diabetic nephropathy was defined by serum Cr concentration above the upper limit of normal or GFR
