HCPLive

Patient-Centered Diabetes Care Works Best in Patients with High HbA1c

WEDNESDAY, Sept. 18 (HealthDay News) -- Patient-centered diabetes care is most effective when targeted to patients with HbA1c >8.5 percent, according to a study published online Aug. 15 in Diabetes Care.

Annabelle S. Slingerland, MD, MPH, from the Leiden University Medical Center in the Netherlands, and colleagues randomized 506 patients with type 2 diabetes seen at 13 hospitals (cluster-randomized) to patient-centered (237 patients) or usual care (controls; 269 patients). Change in HbA1c, quality-adjusted life years (QALYs), and costs were the outcomes of interest. Patients were stratified by baseline HbA1c: <7.0 percent (53 mmol/mol), 7.0 to 8.5 percent, and >8.5 percent (69 mmol/mol).

The researchers found that patient-centered care was most effective and cost-effective in those with baseline HbA1c >8.5 percent, with HbA1c reduction after one year of 0.83 percent and an incremental cost-effectiveness ratio (ICER) of US$261 per QALY. This would translate to a lifetime gain of 0.54 QALYs at a cost of US$3,482 (ICER, US$6,443/QALY). For those with baseline HbA1c 7.0 to 8.5 percent, there was a gain of 0.24 QALY at a cost of US$4,731 (ICER, US$20,086/QALY). For patients with a baseline HbA1c <7.0 percent, care was not cost-effective.

"Patient-centered care is more valuable when targeted to patients with HbA1c >8.5 percent (69 mmol/mol), confirming clinical intuition," the authors write.

Abstract
Full Text (subscription or payment may be required)

Copyright © 2013 HealthDay. All rights reserved.

Most Popular

Recommended Reading

GLP-1 receptor antagonists have been associated with thyroid cancer in rodents, and in fact carry a boxed warning about the potential for cancer in humans. This leads many clinicians to ask if they should be concerned about using these drugs in patients who have or develop specific types of thyroid cancer
Dementia is linked to comorbid diabetes and psychiatric conditions like depression, according to research from University College London.
Seizures and other neurological problems traced to pork tapeworms are a new health threat for the US, the CDC reports.
A recent study examined the cost of biologic and non-biologic DMARDs under Medicare Part D and stand-alone coverage plans.
$vAR$