Finding the clinical utility of 1,5-anhydroglucitol among primary care practitioners.

Autor:	Peabody J; University of California, San Francisco, United States.; University of California, Los Angeles, United States.; QURE Healthcare, United States., Paculdo D; QURE Healthcare, United States., Acelajado MC; QURE Healthcare, United States.; Athens Limestone Hospital, Athens, AL, United States., Burgon T; QURE Healthcare, United States., Dahlen JR; Hikari Dx, Inc., San Diego, CA, United States.
Jazyk:	angličtina
Zdroj:	Journal of clinical & translational endocrinology [J Clin Transl Endocrinol] 2020 Apr 18; Vol. 20, pp. 100224. Date of Electronic Publication: 2020 Apr 18 (Print Publication: 2020).
DOI:	10.1016/j.jcte.2020.100224
Abstrakt:	Background: HbA1c is widely used as the standard measure to track glycemic control in patients with diabetes and pre-diabetes but measures average levels of glycated hemoglobin over two to three months, with limited utility in the presence of recent and/or short-term fluctuations in glycemic control, which are correlated with worse patient outcomes. Methods: We examined the clinical utility of 1-5-anhydroglucitol (1,5-AG) in six different, but common, case types of diabetes patients with short-term glycemic variability. We conducted a randomized controlled trial of simulated patients to examine the clinical practice patterns of primary care physicians before and after introducing 1,5-AG. The 145 participants were randomly assigned into standard care or standard care + 1,5-AG arms. Provider care was reviewed against explicit evidence-based care standards. Results: At baseline, we saw no difference between the two study arms in clinical quality of care provided (p = 0.997). After introduction of 1,5-AG, standard care + 1,5-AG providers performed 3.2% better than controls (p = 0.025. In diagnosis and treatment, there was a slight, but nonsignificant trend toward better care (+1.1%, p = 0.507) for intervention providers. Upon disaggregation by case, almost all the improvement occurred in the medication-induced hyperglycemia patients (+8.1%, p = 0.047). Conclusions: A nationally representative sample of primary care physicians demonstrated that of six different cases used in this study, 1,5-AG was found to be most effective increasing awareness of poor glucose control in medication-induced hyperglycemia. If 1,5-AG is used in this particular circumstance, the overall savings to the healthcare system is estimated to be $28 million. (© 2020 The Authors.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu