Controlling the ABCs of diabetes in clinical practice: a community-based endocrinology practice experience

Determine A1C, blood pressure (BP), and total cholesterol (TC) (Diabetes ABCs) control in a community-based endocrinology practice (CBEP) and compare levels to national averages. Additionally, determine patient factors associated with ABC control.A retrospective chart audit of 395 consecutive patients seen for diabetes management was conducted for years 2000-2004 to examine levels of control of the ABCs. Multivariate models were used to determine patient factors associated with control.Significantly more patients met the goal of A1C7% in the CBEP compared to national estimates (CBEP: 47.1% vs. NHANES 1999-2000: 37%, p=0.003). Similar patterns were observed for BP (CBEP: 53.2% vs. NHANES 1999-2000: 35.8%, p0.0001), TC (CBEP: 82% vs. NHANES 1999-2000: 48.2%, p0.0001), and all three ABCs (CBEP: 22%, vs. NHANES 1999-2000: 7.3%, p0.0001). The proportion of patients meeting all three ABC goals in the CBEP increased significantly over time (p0.0001). Multivariate models demonstrated that patients not needing insulin (p0.0001), and taking fewer BP (p0.0001), and cholesterol-lowering medications (p0.02) were significantly more likely to have ABCs in control.Attainment of ABC goals is feasible in a CBEP and can be achieved at rates higher than national averages. Attention to factors that affect these goals is warranted.