title: Characteristics associated with glycemic control among family medicine patients with type 2 diabetes.
abstract: BACKGROUND
  As new payment models are developed for chronic diseases such as diabetes, there is a need to understand which patient characteristics impact glycemic control. This study examines the relationship between patient variables and glycemic control, defined as a hemoglobin A1c (A1c) level of <7%, in a cohort of family medicine patients with type 2 diabetes.
  
  
  METHODS
  A total of 1,398 medical charts were selected using International Classification of Diseases, Ninth Revision, Clinical Modification codes for diabetes. To gather information not available through chart review, a survey was used to collect data on individual-level characteristics. Information included marital status, education level, income level, insurance status, activity level, receipt of diabetes education, living arrangement, employment status, and annual income. A cross-sectional design was used to obtain, via chart review, data about diabetes outcomes (ie, A1c level, blood pressure, and low-density lipoprotein cholesterol [LDL-C] level).
  
  
  RESULTS
  A mailed survey was completed by 669 patients (response rate, 47.9%). Almost half of patients in this sample achieved the goal A1c level, LDL-C level (ie, <100 mg/dL), and/or blood pressure (ie, <130/<80 mm Hg). Medicare insurance (odds ratio [OR], 2.16 [95% confidence interval {CI}, 1.18-3.96]) and female sex (OR, 1.61 [95% CI, 1.01-2.56]) were associated with glycemic control. Other variables, such as annual income, education level, and receipt of diabetes education, that were expected to impact glycemic control were not significantly associated with an A1c level of <7%.
  
  
  CONCLUSIONS
  The survey response rate was <50%, the study was conducted at a single site, and the chart data were retrospective.
  
  
  CONCLUSIONS
  Our findings indicate that Medicare insurance and female sex were associated with glycemic control. Further evaluation is needed to identify determinants that lead to achievement of optimal glycemic control among individuals with type 2 diabetes.
authors.affiliation: Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA. jkirk@wakehealth.edu
authors.forename: Julienne K
authors.initials: JK
authors.lastname: Kirk
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Davis
authors.forename: Carol A
authors.initials: CA
authors.lastname: Hildebrandt
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Strachan
authors.forename: Madhavi L
authors.initials: ML
authors.lastname: Peechara
authors.forename: Richard
authors.initials: R
authors.lastname: Lord
mesh_terms: D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology; D015444:Exercise; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D038321:Glycemic Index; D015438:Health Behavior; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008077:Lipoproteins, LDL; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin; D008077:Lipoproteins, LDL