Diabetes care and control: the effect of frequent visits to diabetes care center

Abstract

BACKGROUND AND OBJECTIVESFrequent visits to diabetes care clinics linked with better control of diabetes mellitus (DM), but debates exist about how frequently visits should be done. The objective of this study was to assess the effect of frequent visits on diabetes care and control.DESIGN AND SETTINGSA prospective study of 100 diabetic patients attending Prince Abdul-Aziz Bin-Majed Diabetes Care Centre (PAMDCC), Al Madinah Al Munawwarah, Saudi Arabia, during the period from March 2011 through December 2012.METHODSDemographics, lifestyle, and diabetes data were obtained at the index visit. At that and subsequent visits, glycosated hemoglobin (HBA1c), blood pressure (BP) and low-density lipoprotein (LDL) were measured. All these data together with visit number and gap were recorded. Statistical analysis including linear regression analysis was done.RESULTSA significant reduction in the mean of diabetic control parameters was observed at the last visit. The highest mean changes were observed in patients with >6 visits, visit gap ≤1 month, and visit-month index ≥8. Adjusted linear regression showed that each visit significantly lowered HBA1c by 0.25%, BP by 2.1/0.7 mm Hg and 0.2 mmol/L for LDL. The number of visits needed to get HBA1c <7% and BP <130/85 was 8 and 5 visits with a visit-month index of 14 and 5, respectively.CONCLUSIONThe study suggests that frequent visits at short intervals may lead to better diabetes control. Other prospective clinical trial studies are needed to confirm these findings and to outline the appropriate cost-effective intervals and visit gaps.

Access to Transportation and Health Care Visits for Medicaid Enrollees With Diabetes

“…Also, the factors that lead to good glycemic control are multiple and complex . However, evidence suggests that frequent visits lead to better glycemic control . Among other reasons, it allows for better monitoring, early detection, and timely preventive care.…”

“…37 However, evidence suggests that frequent visits lead to better glycemic control. 9,38,39 Among other reasons, it allows for better monitoring, early detection, and timely preventive care. Consequently, missed or delayed diabetes care and the resulting failure to manage the disease can lead to poor quality of life, expensive treatments, and loss of productivity, which in 2012 was estimated to total $245 billion.…”

Relationship between number of contacts between previous dropouts with type 2 diabetes and health care professionals on glycaemic control: A cohort study in public primary health care

“…Among patients with unsatisfactory glycaemic control, an association between visit frequency and better diabetes control has been shown in several studies [7][8][9][10]. According to a U.S. study, patients with T2D with relatively poor glycaemic control showed significant and clinically meaningful improvements in HbA 1c when contacted weekly by members of the health care system [7].…”

“…Recalling T2D dropouts is not necessary without problems. First, although there are former studies suggesting that more frequent contacts with the diabetes care centres predict better diabetes control [7][8][9][10] it is not known whether this is true also among the previous dropouts with T2D. Further, we do not know whether this intervention leads to increased use of the T2D care system by those patients gaining the most from it.…”

Quality of care for type 2 diabetes in Jordan: A national study

“…Patients who visited the health facility 1-4 times/year were 2.36-fold more likely to have glycemic control than those who visited the health facility >10 times/year, after controlling for potential confounders (P<0.001). This may be attributed to uncontrolled hyperglycemia that leads to an increased number of visits or the quality of these visits not meeting the patient's therapeutic needs ( 11 , 12 ).…”