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Care endpoints in adults with type 2 diabetes: screening and therapeutic targets at a Canadian tertiary diabetes care centre

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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.

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