Glucose testing and insufficient follow-up of abnormal results: a cohort study

نویسندگان

  • Lisa M Kern
  • Mark A Callahan
  • David J Brillon
  • Maryelena Vargas
  • Alvin I Mushlin
چکیده

BACKGROUND More than 6 million Americans have undiagnosed diabetes. Several national organizations endorse screening for diabetes by physicians, but actual practice is poorly understood. Our objectives were to measure the rate, the predictors and the results of glucose testing in primary care, including rates of follow-up for abnormal values. METHODS We conducted a retrospective cohort study of 301 randomly selected patients with no known diabetes who received care at a large academic general internal medicine practice in New York City. Using medical records, we collected patients' baseline characteristics in 1999 and followed patients through the end of 2002 for all glucose tests ordered. We used multivariate logistic regression to measure associations between diabetes risk factors and the odds of glucose testing. RESULTS Three-fourths of patients (78%) had at least 1 glucose test ordered. Patient age (> or = 45 vs. < 45 years), non-white ethnicity, family history of diabetes and having more primary care visits were each independently associated with having at least 1 glucose test ordered (p < 0.05), whereas hypertension and hyperlipidemia were not. Fewer than half of abnormal glucose values were followed up by the patients' physicians. CONCLUSION Although screening for diabetes appears to be common and informed by diabetes risk factors, abnormal values are frequently not followed up. Interventions are needed to trigger identification and further evaluation of abnormal glucose tests.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

بررسی ارتباط بین تست غیرطبیعی چالش گلوکزوپیامدهای بارداری

Background and Objective: Glucose Challenge Test (GCT) is done for pregnant women during the week 24-28 of gestation to screen gestational diabetes. In patients with abnormal GCT, a glucose tolerance test (GTT) is performed, and if GTT is impaired, the patient is diagnosed with gestational diabetes. There is some evidence suggesting that abnormal GCT alone is associated with adverse pregnancy o...

متن کامل

Changes in Impaired Fasting Glucose among Tehranian adolescents through a decade of follow up: Tehran Lipid and Glucoes Study

Introduction: The prevalence of impaired fasting glucose (IFG) is increasing worldwide, affecting people in all age groups, including adolescents. The objective of this study was to explore changes in IFG prevalence during a decade long follow-up in adolescent participants of a population-based cohort study from Iran. Materials and Methods: We included 2998 participants, aged 11-19 in study per...

متن کامل

مروری بر مطالعات کوهورت مبتنی بر جمعیت در ایران

Background and purpose: Cohort studies are one of the best types of observational studies in investigating the causal relationship, diseases etiology, and determining the incidence and natural history of diseases. In recent decades cohort studies played a major role in identification of environmental, cardiovascular and cancers risk factors. Considering the important role of cohort studies in p...

متن کامل

Lipid Concentration at 13-23 Weeks of Pregnancy and the Risk of Abnormal Glucose Challenge Test (GCT)

Abstract Objective: The aim of this study was evaluating the relationship between maternal serum lipid measured at 13-23 weeks of pregnancy and subsequent glucose intolerance. Materials and Methods: In a prospective study, 624 pregnant women prior to 23 weeks were eligible for the study. Primarily, serum levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride were ...

متن کامل

شیوع دیابت در دوران پس از زایمان در زنان با سابقه دیابت بارداری

Background: Recurrent GDM are more common in women with previous GDM. Also GDM is an important risk factor for abnormal glucose tolerance and type 2 diabetes during postpartum. This study aims to determine the prevalence of postpartum IGT and T2DM in women with previous GDM. Methods: A cohort study was conducted on 2416 pregnant women referred to five Tehran university hospital clinics. The un...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • BMC Health Services Research

دوره 6  شماره 

صفحات  -

تاریخ انتشار 2006