Endocrine Abstracts

OBJECTIVE: To evaluate if follow up in a specialty clinic for Diabetics can result in lower LDL levels.

METHODS: A Veterans Administration (VA) diabetes clinic established in 1996 consisted of 5 academic endocrinologists, nurse practitioner, endocrinology fellows, rotating medical housestaff, pharmacist, nutritionist and nurse. All patients enrolled in diabetes clinic for at least one year had their electronic medical record reviewed retrospectively for data relating to American Diabetes Association standards of care. Data for August1997-August1998 was entered into an Excel97 spreadsheet that was used for descriptive statistics and for paired t-test. Labs were standard tests by VA clinical laboratory. LDL-cholesterol was calculated by Friedwald equation.

RESULTS: Description of patient population: 416 Veterans were in the diabetes clinic for August1997-August1998. Electronic medical record could not identify basic demographics for the patient population studied. The demographics for VA indicate more than 90% were male, over 40 years-old with type-2 diabetes.

Glycemic control: HbA1c was measured in the majority each quarter; average was 7.9%plus/minus1.4% (n=394) for first quarter and 6.9%plus/minus1.2% (n=355) for fourth quarter. Improvement from first to last quarter is significant at p<0.001 by paired t-test.

Lipid control: LDL-cholesterol was measured at least once in 90% of patients; average was 121 milligrams per decilitre plus/minus28 milligrams per deciliter during the first 6 months and 99 milligrams per decilitre plus/minus26 milligrams per decilitre the last 6 months. Improvement is significant at p<0.001 by paired t-test. Last 6 months, 273 out of 323 (84.5%) that were measured had achieved an LDL 130 milligrams per decilitre or less. 195 patients were on statin therapy. Glycemic control was not related to lipid control.

CONCLUSIONS: Endocrinologists are able to improve the LDL-cholesterol levels in Diabetic patients; 65.1% achieving less than 130 milligrams per decilitre after being followed in a diabetes clinic for at least 1 year.