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Abstract
Objectives
Though national diabetes guidelines recommend targets for various health parameters,
past studies have demonstrated a gap between recommendations and real-life practice.
The objectives of our study were to assess 1) measurements in in type 2 diabetes (T2DM)
care performed by diabetologists in tertiary care, 2) whether measurements were within
recommended targets by Canadian guidelines, and 3) how these measurements compared
to previously published Canadian studies.
Methods
A retrospective chart review analyzed electronic medical records of patients seen
by diabetes specialists at the MUHC. Patients between the ages of 18 to 75 years old
diagnosed with T2DM were assessed for the following: blood pressure < 130/80, LDL-cholesterol
(LDL-c) ≤ 2 mmol/L, and glycated hemoglobin (HbA1c) ≤ 7%. Measured urine albumin:
creatinine ratio (uACR) was also assessed. Comparisons were made to existing literature.
Results
The percentage of patients with recent screening of HbA1c, LDL-c, blood pressure,
and uACR were higher than prior studies. The calculated mean for HbA1c, LDL-c, and
blood pressure were compatible with prior studies. The percentage of measurements
achieving target were comparable to subspecialty care previously documented but differed
from values from primary care.
Conclusion
Patients with T2DM at the MUHC receive guideline-based measurements of health parameters
that exceed results of prior studies. Achievement of target values was closer to data
from Canadian specialists than that of primary care. Though further analyses are necessary
to help implement effective strategies for improvement, quality assurance is nonetheless
an essential part of ensuring the standards of tertiary care.
Keywords
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Article Info
Publication History
Accepted:
July 9,
2022
Received in revised form:
June 23,
2022
Received:
April 13,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Key Messages:
There are care gaps in both the screening and achievement of targets in key endpoints in diabetes management worldwide and in Canada.
Our tertiary care center exceeds prior studies for achieved screening, but is on par with other specialists for achieved targeted endpoints.
Clinical audits provide information on current diabetes care in both primary and specialty practices and can ensure improvement in quality care.
Funding Statement: Self-funded within the Division of Endocrinology at the McGill University Health Centre
Identification
Copyright
© 2022 Canadian Diabetes Association.
