George L. Jackson, PhD, MHA and David Edelman, MD, MHS, MS. Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street (152), Durham, NC 27705, 919-286-0411 x 5648, george_jackson@alumni.unc.edu

Objective: Describe the degree of simultaneous control of intermediate outcomes among VA diabetics. Outcomes include glycosylated hemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C).

Methods: We established a cohort of 224,221 patients (alive October 1, 1999) using the VA Diabetes Registry and Dataset and VA Medical SAS Datasets. Diabetes designation was based on having ≥ 1 filled diabetes related prescription and ≥ 2 outpatient and/or ≥ 1 inpatient encounter with an associated diabetes diagnosis in FY 1999. Of 215,947 cohort members with ≥ 1 VA encounter in FY 2000, 102,766 had recorded results for all study outcomes.

Control Definitions: Moderate control is simultaneously having mean HbA1c < 9.0%, SBP < 140 mmHG, DPB < 85 mmHG, LDL-C < 130 mg/dL, and HDL-C > 40 mg/Dl in FY 2000. Tight control is simultaneously having mean HbA1c < 7.0%, SBP < 130 mmHG, DPB < 85 mmHG, LDL-C < 100 mg/dL, and HDL-C > 45 mg/DL in FY 2000.

Results: 13.23% of patients had moderate control. For individual outcomes, the following percentages of patients had moderate control: HbA1c (81.01%), SBP (49.47%), DBP (84.70%), LDL-C (77.54%), and HDL-C (47.25%). 1.02% of patients had tight control. For individual outcomes, the following percentages of patients had tight control: HbA1c (35.70%), SBP (26.65%), DBP (69.59%), LDL-C (41.63%), and HDL-C (29.28%).

Implications: The low rate of simultaneous control may indicate a need for greater attention to individual treatment characteristics of intermediate outcomes when planning care.

Learning Objectives:

• Describe the level of simultaneous control of major intermediate diabetes outcomes among patients of the Veterans Health Administration
• Describe the level of control of individual major intermediate diabetes outcomes among patients of the Veterans Health Administration
• Discuss the implications of lack of simultaneous control of major intermediate diabetes outcomes on patient treatment and clinical research

Keywords: Diabetes, Veterans

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.