Patient age, ethnicity, medical history, and risk factor profile, but not drug insurance coverage, predict successful attainment of glycemic targets: Time 2 Do More Quality Enhancement Research Initiative (T2DM QUERI).
OBJECTIVE
To identify factors in patients with type 2 diabetes and A1C >7.0% associated with attainment of A1C ≤ 7.0%.


METHODS
We used a prospective registry of 5,280 Canadian patients in primary care settings enrolled in a 12-month glycemic pharmacotherapy optimization strategy based on national guidelines.


RESULTS
At close out, median A1C was 7.1% (vs. 7.8% at baseline) with 48% of subjects achieving A1C ≤ 7.0% (P < 0.0001). Older patients of Asian or black origin, those with longer diabetes duration, those with lower baseline A1C, BMI, LDL cholesterol, and blood pressure, and those on angiotensin receptor blockers and a lower number of antihyperglycemic agents, were more likely to achieve A1C ≤ 7.0% at some point during the study (all P < 0.0235). Access to private versus public drug coverage did not impact glycemic target realization.


CONCLUSIONS
Patient demography, cardiometabolic health, and ongoing pharmacotherapy, but not access to private drug insurance coverage, contribute to the care gap in type 2 diabetes.
Teoh
Hwee
H
Division of Cardiac Surgery, Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Braga
Manoela F B
MF
Casanova
Amparo
A
Drouin
Denis
D
Goodman
Shaun G
SG
Harris
Stewart B
SB
Langer
Anatoly
A
Tan
Mary K
MK
Ur
Ehud
E
Yan
Andrew T
AT
Zinman
Bernard
B
Leiter
Lawrence A
LA
D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000208:ethnology / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D019458:Insurance Coverage; D007356:Insurance, Pharmaceutical Services; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D057911:Angiotensin Receptor Antagonists; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
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