Glycemic control and morbidity in the Canadian primary care setting (results of the diabetes in Canada evaluation study)
Section snippets
Research design and methods
A cross-sectional chart audit methodology was employed. The Canadian Medical Association publishes a comprehensive database [13] on an annual basis. At the time of this study, the database contained 26,174 PCPs. Physicians who had requested not to be contacted for research were excluded, resulting in a list of 20,423 PCPs. In order to obtain a final target sample of 300 PCPs and estimating a minimal response rate of 10%, 3000 PCPs were randomly selected from this list and sent recruitment
Results
Participating PCPs had been in practice for a mean 17.5 years. Seventy-nine percent of PCPs were male and 15% worked in rural practices. Fifty-six percent of PCPs worked in group practice, 73% were affiliated with a hospital and 81% of PCPs reported that they had attended a continuing education event on T2DM in the past year.
The mean patient age at review was 62.7 years, 54% were male, and the mean body mass index (BMI) was 31 kg/m2. The dominant drug insurance coverage was provincial formulary
Conclusions
This large, national, cross-sectional study depicts the disease burden associated with T2DM in the primary care setting in Canada. Further, it is one of the few to provide an evaluation of T2DM by duration of disease. Findings suggest that a considerable proportion of T2DM patients in Canada are not well controlled and that disease burden is quite high.
There are few published, national, studies assessing glycemic control within the family practice setting. The mean A1C (7.3%) and the percentage
Acknowledgements
This study was funded by GlaxoSmithKline. Special thanks to Lisa Mullett from GlaxoSmithKline for her input throughout the study and to Dr. Edward Adlaf from the Centre for Addiction and Mental Health for his consul regarding the analyses. As well, the authors would like to thank all the physicians for their participation. Stewart B. Harris is a Career Scientist of the Ontario Ministry of Health and Long Term Care.
References (28)
- et al.
Clinical inertia
Ann. Intern. Med.
(2001) Intensive blood–glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)
Lancet
(1998)Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34)
Lancet
(1998)- et al.
Clinical practice guidelines for the management of diabetes in Canada, Canadian Diabetes Association
CMAJ
(1998) Clinical practice guidelines for the prevention and management of diabetes in Canada
Can. J. Diab.
(2003)- et al.
Care of patients with type II diabetes: a study of family physicians’ compliance with clinical practice guidelines
J. Fam. Pract.
(1997) - et al.
Type 2 diabetes in family practice: room for improvement
Can. Fam. Physician
(2003) - et al.
Physician and patient prevention practices in NIDDM in a large urban managed-care organization
Diabetes Care
(1995) - et al.
Survey and audit of diabetes care in general practice in south London
Br. J. Gen. Pract.
(1991) - et al.
Diabetes care in general practice: an approach to audit of process and outcome
Br. J. Gen. Pract.
(1993)
Practice patterns of rural family physicians based on the American Diabetes Association standards of care
J. Community Health
Glycemic control changes between 1988 and 2000 among US adults diagnosed with type 2 diabetes
Diabetes Care
The role of patient, physician and systemic factors in the management of type 2 diabetes mellitus
Fam. Pract.
Cited by (179)
Adherence to diabetes clinical practice guidelines to improve prevention and treatment of cardiovascular disease in Quebec: A retrospective cohort 2017-2020
2022, Diabetes Epidemiology and ManagementGlycemic Control Among People With Diabetes in Ontario: A Population-Based Cross-Sectional Study
2021, Canadian Journal of DiabetesType 2 Diabetes and the Reduction of Cardiovascular Risk: Sorting Out the Actors and the Roles
2018, Canadian Journal of CardiologyDyslipidemia
2018, Canadian Journal of DiabetesCitation Excerpt :A national cross-sectional chart audit study of 2,473 Canadians with type 2 diabetes revealed that 55% of individuals with a diabetes diagnosis of 2 years' duration also had dyslipidemia. This proportion rose to 66% in those with diabetes for 15 years (14). Therefore, a fasting lipid profile (total cholesterol [TC], HDL-C, TG and calculated LDL-C) should be conducted at the time of diagnosis of diabetes and if treatment is not warranted, the assessment should be repeated annually or as clinically indicated.