Patterns of type 2 diabetes monitoring in rural towns: How does frequency of HbA1c and lipid testing compare with existing guidelines?. (18th April 2016)

• Record Type: Journal Article
• Authors: Paul, Christine L.; Piterman, Leon; Shaw, Jonathan E.; Kirby, Catherine; Barker, Daniel; Robinson, Jennifer; Forshaw, Kristy L.; Sikaris, Kenneth A.; Bisquera, Alessandra; Sanson‐Fisher, Robert W.
• Is Part Of: Australian journal of rural health. Volume 24:Number 6(2016)
• Page Start: 371
• Page End: 377
• Publication Date: 2016-04-18
• Subjects: diabetes mellitus -- HbA1c -- patient care management -- rural health -- vulnerable populations; Rural health -- Periodicals; Rural health -- Australia -- Periodicals; 613
• DOI: 10.1111/ajr.12283
• Languages: English
• ISSNs: 1038-5282

Abstract

Abstract: Objective: To indicate levels of monitoring of type 2 diabetes in rural and regional Australia by examining patterns of glycated haemoglobin (HbA1c) and blood lipid testing. Design and Setting: Retrospective analysis of pathology services data from twenty regional and rural towns in eastern Australia over 24 months. Participants: Of 13 105 individuals who had either a single HbA1c result ≥7.0% (53 mmol mol −1 ); or two or more HbA1c tests within the study period. Main outcome measures: Frequency of testing of HbA1c and blood lipids (cholesterol, low‐density lipoprotein (LDL) cholesterol, high‐density lipoprotein (HDL) cholesterol and triglycerides) were compared with guideline recommendations. Results: About 58.3% of patients did not have the recommended 6‐monthly HbA1c tests and 30.6% did not have annual lipid testing. For those who did not receive tests at the recommended interval, the mean between‐test interval was 10.5 months (95% CI = 7.5–13.5) rather than 6 months for HbA1c testing; and 15.7 (95% CI = 13.3–18.1) months rather than annually for blood lipids. For those with at least one out‐of‐range test result, 77% of patients failed to receive a follow‐up HbA1c test and 86.5% failed to receive a follow‐up blood lipid test within the recommended 3 months. Patients less than 50 years of age, living in a more remote area and with poor diabetes control were less likely to have testing at the recommended intervals ( P < 0.0001). Conclusions: Although poor diabetes testing is not limited to rural areas, more intensive diabetes monitoring is likely to be needed for patients living in non‐metropolitan areas, particularly for some subgroups.