Premium
Patterns of type 2 diabetes monitoring in rural towns: How does frequency of HbA1c and lipid testing compare with existing guidelines?
Author(s) -
Paul Christine L.,
Piterman Leon,
Shaw Jonathan E.,
Kirby Catherine,
Barker Daniel,
Robinson Jennifer,
Forshaw Kristy L.,
Sikaris Kenneth A.,
Bisquera Alessandra,
SansonFisher Robert W.
Publication year - 2016
Publication title -
australian journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.48
H-Index - 49
eISSN - 1440-1584
pISSN - 1038-5282
DOI - 10.1111/ajr.12283
Subject(s) - medicine , diabetes mellitus , guideline , cholesterol , blood lipids , type 2 diabetes , confidence interval , glycated hemoglobin , total cholesterol , emergency medicine , endocrinology , pathology
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.