Controlling the ABCs of diabetes in clinical practice: a community-based endocrinology practice experience.
OBJECTIVE
Determine A1C, blood pressure (BP), and total cholesterol (TC) (Diabetes ABCs) control in a community-based endocrinology practice (CBEP) and compare levels to national averages. Additionally, determine patient factors associated with ABC control.


METHODS
A retrospective chart audit of 395 consecutive patients seen for diabetes management was conducted for years 2000-2004 to examine levels of control of the ABCs. Multivariate models were used to determine patient factors associated with control.


RESULTS
Significantly more patients met the goal of A1C <7% in the CBEP compared to national estimates (CBEP: 47.1% vs. NHANES 1999-2000: 37%, p=0.003). Similar patterns were observed for BP (CBEP: 53.2% vs. NHANES 1999-2000: 35.8%, p<0.0001), TC (CBEP: 82% vs. NHANES 1999-2000: 48.2%, p<0.0001), and all three ABCs (CBEP: 22%, vs. NHANES 1999-2000: 7.3%, p<0.0001). The proportion of patients meeting all three ABC goals in the CBEP increased significantly over time (p<0.0001). Multivariate models demonstrated that patients not needing insulin (p<0.0001), and taking fewer BP (p<0.0001), and cholesterol-lowering medications (p<0.02) were significantly more likely to have ABCs in control.


CONCLUSIONS
Attainment of ABC goals is feasible in a CBEP and can be achieved at rates higher than national averages. Attention to factors that affect these goals is warranted.
Varma
Swarna
S
Pittsburgh Endocrinology and Diabetes Associates, Bridgeville, PA 15017, USA. varmss@aol.com
Boyle
Laura L
LL
Varma
Manu R
MR
Piatt
Gretchen A
GA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003153:Community Health Services / Q000592:standards / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology*; D004704:Endocrinology / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000453:epidemiology; D006949:Hyperlipidemias / Q000188:drug therapy / Q000453:epidemiology; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies
D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D002784:Cholesterol