Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
Introduction
Diabetes mellitus is a key predictor of mortality in rheumatoid arthritis (RA) patients. Both RA and diabetes increase the risk of cardiovascular disease (CVD), yet understanding of how comorbid RA impacts the receipt of guideline-based diabetes care is limited. The purpose of this study was to examine how the presence of RA affected hemoglobin A1C (A1c) and lipid measurement in older adults with diabetes.
Methods
Using a retrospective cohort approach, we identified beneficiaries [greater than or equal to] 65 years old with diabetes from a 5% random national sample of 2004-05 Medicare patients (N=256331), then examined whether these patients had comorbid RA and whether they received guideline recommended A1C and lipid testing in 2006. Multivariate logistic regression was used to examine the effect of RA on receiving guideline recommended testing, adjusting for baseline sociodemographics, comorbidities, and health care utilization.
Results
Two percent of diabetes patients had comorbid RA (N=5572).Diabetes patients with comorbid RA were more likely than those without RA to have baseline cardiovascular disease (such as 17% more congestive heart failure), diabetes-related complications including kidney disease (19% higher), lower extremity ulcers (77% higher), and peripheral vascular disease (32% higher). In adjusted models, diabetes patients with RA were less likely to receive recommended A1c testing (Odds Ratio (OR) 0.84, CI 0.80-0.89) than those without RA, but were slightly more likely to receive lipid testing (OR 1.08, CI 1.01-1.16).
Conclusions
In older adults with diabetes, the presence of comorbid RA predicted lower rates of A1c testing but slightly improved lipid testing. Future research should examine strategies to improve A1c testing in patients with diabetes and RA, in light of increased CVD and microvascular risks in patients with both conditions.
Full article: http://arthritis-research.com/content/pdf/ar3915.pdf
Diabetes mellitus is a key predictor of mortality in rheumatoid arthritis (RA) patients. Both RA and diabetes increase the risk of cardiovascular disease (CVD), yet understanding of how comorbid RA impacts the receipt of guideline-based diabetes care is limited. The purpose of this study was to examine how the presence of RA affected hemoglobin A1C (A1c) and lipid measurement in older adults with diabetes.
Methods
Using a retrospective cohort approach, we identified beneficiaries [greater than or equal to] 65 years old with diabetes from a 5% random national sample of 2004-05 Medicare patients (N=256331), then examined whether these patients had comorbid RA and whether they received guideline recommended A1C and lipid testing in 2006. Multivariate logistic regression was used to examine the effect of RA on receiving guideline recommended testing, adjusting for baseline sociodemographics, comorbidities, and health care utilization.
Results
Two percent of diabetes patients had comorbid RA (N=5572).Diabetes patients with comorbid RA were more likely than those without RA to have baseline cardiovascular disease (such as 17% more congestive heart failure), diabetes-related complications including kidney disease (19% higher), lower extremity ulcers (77% higher), and peripheral vascular disease (32% higher). In adjusted models, diabetes patients with RA were less likely to receive recommended A1c testing (Odds Ratio (OR) 0.84, CI 0.80-0.89) than those without RA, but were slightly more likely to receive lipid testing (OR 1.08, CI 1.01-1.16).
Conclusions
In older adults with diabetes, the presence of comorbid RA predicted lower rates of A1c testing but slightly improved lipid testing. Future research should examine strategies to improve A1c testing in patients with diabetes and RA, in light of increased CVD and microvascular risks in patients with both conditions.
Full article: http://arthritis-research.com/content/pdf/ar3915.pdf