(DCP024) ADHERENCE TO GUIDLINE-RECOMMENDED MONITORING OF IMPORTANT PARAMETERS RELATING TO DIABETES MELLITUS IN ONTARIO
Friday, October 27, 2023
15:30 – 15:45 EST
Location: ePoster Screen 11
Disclosure(s):
Nicole Pun, MD MScCH FRCPC: No financial relationships to disclose
Baiju R. Shah, MD PhD: No relevant disclosure to display
Background: Diabetes mellitus is a global chronic health concern with significant implications on cardiovascular and other health indicators. The chronic complications of diabetes can often be prevented or delayed by appropriate screening. In Canada, we have previous reports on its prevalence, incidence, and mortality but sparse research on rates of adherence to guideline-based recommendations for monitoring. The objective of this project was to report on rates of monitoring for important diabetes-related parameters based on recommendations from the 2018 Diabetes Canada Clinical Practice Guidelines.
METHODS AND RESULTS: Electronic medical record (EMR) data between January 2018 and December 2019 were obtained from 38 primary care practices in Ontario, and de-identified. Documented diagnoses and prescription records were used to identify a cohort of patients living with type 1 (n=818) or type 2 diabetes (n=11343). Frequency and results of important parameters involved in the monitoring of diabetes were collected. Patients living with T2DM were significantly older and had higher body mass index and blood pressure. Those living with T1DM had significantly higher HbA1C and LDL-cholesterol. Over the two years of data, 54.5% of patients living with T2DM had HbA1c results recorded, 54.0% had eGFR results recorded, and 50.3% had LDL-cholesterol results recorded; the numbers were even lower for patients living with T1DM.
Conclusion: Adherence to guideline-recommended monitoring of parameters such as HbA1C, eGFR, and LDL-cholesterol appears to be suboptimal in the T2DM population in Ontario. Numbers were worse with T1DM but specialist care with an endocrinologist as opposed to primary care may account for some of this discrepancy. Further research should explore factors contributing to adherence to monitoring recommendations in the primary care population to provide guidance on strategies or policies that may improve care.
