Diabetes on a cardiovascular ward: adherence to current recommendations.
Bethel MA., Alexander J., Lane J., Barkauskas C., Feinglos MN.
OBJECTIVES: Improving diabetes and blood pressure control decreases the incidence and progression of microvascular disease. Likewise, screening for microvascular complications is beneficial in the early detection and treatment of these disorders. However, adherence to practice guidelines for screening and treatment in patients with diabetes is suboptimal. This study describes a group of patients with diabetes who were admitted to a cardiology service at an academic medical center. METHODS: Patient interview and chart review were used to determine glycemic control and compliance with practice guidelines. RESULTS: The mean hemoglobin A1c was 8.3%. Only 69% of patients received ophthalmologic examinations, and fewer were screened for nephropathy. Thirty-five percent of patients monitored home blood glucoses less than daily. Nearly 17% had no hemoglobin A1c or lipid checks during the 3 months before admission. CONCLUSIONS: For a group of poorly controlled patients with diabetes who are at high risk for cardiovascular disease, adherence to practice guidelines and the level of diabetes control is inadequate.