Adequacy of glycemic, lipid, and blood pressure management for patients with diabetes in a managed care suing

OBJECTIVE- We conducted a retrospective study to evaluate the adequacy of glycemic, lipid, and blood pressure (BP) management for diabetic patients in a managed care organization (MCO). RESEARCH DESIGN AND METHODS- Patients aged greater than or equal to18 years with diabetes (n = 7,114) were retrospectively identified over a 2-year period from the MCO's administrative database based on the Health Plan Employer Data and Information Set 2000 selection criteria using pharmacy, laboratory, and encounter data. Analyses examined demographics and percentages of patients tested and meeting American Diabetes Association goals for HbA, lipids, and BP, both overall and for those receiving medication treatment versus no treatment. RESULTS- Testing rates for AlC, LDL cholesterol, and BP were 77, 54, and 95%, respectively. The percentage of patients tested who were at goal were 37% for AlC, 23% for LDL cholesterol, and 41 % for systolic BP. Of the patients in our sample, 72% were treated for glycemic control, 64% were treated for BP control, and only 28% were treated for lipid control. Of the patients who received medication treatment, less than one-third were at goal for AlC (29%) and LDL cholesterol (32%), whereas 40% were at goal for systolic BP. CONCLUSIONS- We found that although a large percentage of diabetic patients were tested for AlC, LDL cholesterol, and systolic BP, a much smaller percentage had reached their respective goals. More aggressive glycemic, lipid, and BP management appears to be needed to improve care for these patients.