Can a diabetic's likelihood of developing complications depend on picking the right doctor? A study suggests it can.
Published Online: February 11, 2014FOR IMMEDIATE RELEASE FEBRUARY 11, 2014
AJMC Study: Better Diabetes Care Meant Fewer Complications
PLAINSBORO, N.J. – What if the chance of having complications from diabetes came down to picking the right doctor?
A study of a group of manufacturing workers published in the most recent issue of The American Journal of Managed Care
found that better care can make a difference, and can even compensate for being sicker at the outset.
Better care, in this case, meant having a doctor who tracked three key health measures: glycated hemoglobin, lipids and microalbuminuria. The study tracked 1,797 employees with diabetes from Alcoa Aluminum, who were followed from 2003 to 2009. Those with diabetes who had all three measures tracked starting in the first year of the study were compared over time with those who received less complete testing.
Since the study subjects all had the same health plan, researchers could isolate the effect of the quality of care itself, not coverage.
Researchers compared long-term health results of those diabetics whose doctors tracked all three measures, compared with diabetics whose doctors did not. The study looked at time to progression for four common complications from diabetes: coronary artery disease, stroke, heart failure and renal disease.
Differences between the two groups were significant. Those who did not have all three health measures tracked were more likely to have heart failure or renal disease, and those who had all three measured tracked from the beginning were less likely to have complications overall. Notably, only 15 percent of the diabetes in the group had all three measured checked at the beginning of the study period.
Researchers noted the difficulty in assessing how care plays out over time. Did those patients who had the most symptoms at the beginning seek better care, or take better of themselves in other ways? “It is noteworthy that in the primary test of the hypothesis, the baseline characteristics created an uneven playing field, with more ostensibly sick patients having a higher rate of better care; thus, the deck was stacked against those with better care having better outcomes, an effect that began to be visually apparent in the third observation year,” the researchers wrote. For the full study, click here.
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