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A practical way to quicker control of blood sugar, BP and Cholesterol

ORIGINAL INVESTIGATION

Encounter Frequency and Serum Glucose Level,Blood Pressure, and Cholesterol Level Control in Patients With Diabetes Mellitus

Fritha Morrison, MPH; Maria Shubina, ScD; Alexander Turchin, MD, MS

Background: More frequent patient-provider encounters may lead to faster control of hemoglobin A1c level,blood pressure (BP), and low-density lipoprotein (LDL)cholesterol (LDL-C) level (hereafter referred to as hemoglobin A1c, BP, and LDL-C) and improve outcomes, but no guidelines exist for how frequently patients with diabetes mellitus (DM) should be seen.

Methods: This retrospective cohort study analyzed 26 496 patients with diabetes and elevated hemoglobin A1c, BP, and/or LDL-C treated by primary care physicians at 2 teaching hospitals between January 1, 2000, and January 1, 2009. The relationship between provider encounter (defined as a note in the medical record) frequency and time to hemoglobin A1c, BP, and LDL-C control was assessed.

Results: Comparing patients who had encounters with their physicians between 1 to 2 weeks vs 3 to 6 months, median time to hemoglobin A1c less than 7.0% was 4.4 vs 24.9 months (not receiving insulin) and 10.1 vs 52.8 months (receiving insulin); median time to BP lower than 130/85mm Hg was 1.3 vs 13.9 months; and median time to LDL-C less than 100 mg/dL was 5.1 vs 32.8 months, respectively (P.001 for all). In multivariable analysis, doubling the time between physician encounters led to an increase in median time to hemoglobin A1c (not receiving [35%] and receiving [17%] insulin), BP (87%),

and LDL-C (27%) targets (P.001 for all). Time to control decreased progressively as encounter frequency increased up to once every 2 weeks for most targets, consistent

with the pharmacodynamics of the respective medication classes.

Conclusions: Primary care provider encounters every 2 weeks are associated with fastest achievement of hemoglobin A1c, BP, and LDL-C targets for patients with diabetes mellitus.

Arch Intern Med. 2011;171(17):1542-1550

The weekly or fortnightly visits in this study is not practical in our set up due to financial and logistic reasons.

Here I am offering a practical alternative.

All my clinic patients are offered free remote monitoring of blood sugar, BP, Lipids, Thyroid function or any other parameter through an App which is freely downloaded into their smartphone or through their computer.

For those who are not able to see me in the clinic for financial or logistic reasons are offered the same facility at a nominal price. A year of remote monitoring costs less than one clinic visit. Various monitoring packages are available at http://www.drnoblezachariah.com/home/health-monitoring . Monitoring can be custom made also.

Original Source:http://www.medicalnewstoday.com/articles/235041.php

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