Introduction Diabetes is a chronic illness affecting 6.3% of the population in the United States. It requires continuing medical care and patient self-management education to prevent complications. American Diabetes Association is the nation's leading nonprofit health organization providing diabetes research and education to the health care professionals regarding treatment goals and tools to evaluate the quality of care, which favorably affects the health outcomes of patients with diabetes.
Aim To compare the compliance of a university internal medicine clinic with national guidelines set forth by the American Diabetes Association.
Methods The medical records of all patients with diabetes treated in an outpatient university internal medicine clinic were retrospectively reviewed for the assessment of monitoring guidelines. Inclusion criteria included all diabetics ages 18 to 100 seen in the clinic within the past year. The following five parameters were monitored: hemoglobin AIC: every 3 to 6 months, with the minimum of twice yearly; LDL/triglycerides: yearly; urine microalbumin: yearly; foot examination: every visit with detailed examination yearly; dilated eye examination: yearly. These specific parameters measured were taken from “Standards of Medical Care for Patients with Diabetes Mellitus” (Diabetes Care 2003;26 Supplt 1). The chart review took place over a 6-month period.
Results After data collection was completed, the results were tabulated and percent compliance was calculated. Of 728 records reviewed, 462 patients (63%) had HbA1C, 392 patients (53%) had LDL/TG, 264 patients (36%) had urine microalbumin, 181 patients (24%) had foot examination, and 251 patients (34%) had eye examination done within the past year, in compliance with the guidelines set forth by the American Diabetes Association.
Conclusion The data revealed that HbA1C and lipid panel were the most frequently monitored parameters by internal medicine residents. Less emphasis was paid on foot examination. This study suggests that most patients at the medicine clinic did not receive full monitoring in all of the criteria laid out by the American Diabetes Association guidelines. Causes of lower compliance need to be identified and addressed with system improvements.
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