Monitoring Thyroid Function Tests in Patients With Type 1 Diabetes Mellitus: Adherence to Recommended Guidelines and Comparison of Practice Patterns in a Health Care System

Abstract Approximately 1.7 million people in the U.S. have type 1 diabetes mellitus. Autoimmune thyroid disease occurs 17 to 30% of patients with diabetes. The American Diabetes Association recommends that function be assessed at diagnosis and repeated every 2 years thereafter or sooner if clinically indicated. With Centricity, our former electronic medical records (EMR) system, an EMR aid automatically imported key metrics including TSH test. Our new MedConnect, does not imports these metrics. We hypothesized screening rate for dysfunction diabetic would higher previous system than system. also followed by endocrinologist those a primary care physician. Methods: compared practice patterns Centricity (from June 1, 2013, May 30, 2016) versus MedConnect January 2017, December 31, 2019) both endocrinology clinics. A total 502 (271 231 MedConnect) were identified chart review age ≥18 ICD 9/10 codes mellitus outpatient clinics multicenter Results: Baseline was done 253 271 (93.4%) 181 (78.4%) patients. odds baseline 3.88 times (OR = 3.88, 95% CI=2.19,6.88). Of 214 normal TSH, 135 (63.1%) had repeat 1-2 years; 136 86 (63.2%) years. 434 81 (18.6%) abnormal TSH. patients, 67 (82.7%) hypothyroidism, (1.2%) hyperthyroidism, 8 (9.8%) subclinical 5 (6.1%) hyperthyroidism. 380 (75.7%) 122 (24.3%) provider. Among endocrinologist, 348 (91.6%) result. Only (70.5 %) physician Endocrinologists 4.6 physicians (p <0.0001). Conclusion: Thyroid all recommended intervals per guidelines. Higher rates seen aid. screened significantly more physicians. Education providers regarding guidelines is needed, addition may help improve detecting