Clinical and Economic Benefits Associated With the Achievement of Both HbA1c and LDL Cholesterol Goals in Veterans With Type 2 Diabetes Featured Article:

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Presentation transcript:

Clinical and Economic Benefits Associated With the Achievement of Both HbA1c and LDL Cholesterol Goals in Veterans With Type 2 Diabetes Featured Article: Lizheng Shi, P.H.D., Xin Ye, P.H.D., Mei Lu, M.S., Eric Q. Wu, P.H.D., Hari Sharma, B.S., Darren Thomason, B.A., Vivian A. Fonseca, M.D. Diabetes Care Volume 36: October, 2013

STUDY OBJECTIVE This study compared the clinical and economic benefits of dual-goal achievement: HbA1c <7% (53 mmol/mol) LDL cholesterol (LDL-C) <100 mg/dL Achievement of only the LDL-C goal or only the HbA1c goal was achieved in veterans with T2DM Shi L. et al. Diabetes Care 2013;36:

STUDY DESIGN AND METHODS Electronic medical records (Veterans Integrated Service Network 16) were evaluated in adult T2DM patients with two or more measurements of LDL-C and HbA1c between 1 January 2004 and 30 June 2010 Cox proportional hazards models were used to compare microvascular and cardiovascular outcomes by goal achievement status Generalized linear regression models were used to assess diabetes-related resource use (hospitalization days and number of outpatient visits) and medical service costs Shi L. et al. Diabetes Care 2013;36:

RESULTS Relative to achieving only the LDL-C goal, dual-goal achievement was associated with lower risk of microvascular complications, acute coronary syndrome, percutaneous coronary intervention, and coronary artery bypass graft (CABG) Dual-goal achievement was also associated with fewer hospitalization days and outpatient visits, as well as lower diabetes-related annual medical costs Compared with achievement of only the HbA1c goal, dual- goal achievement was associated with lower risk of the composite cardiovascular-related end point and CABG, as well as fewer outpatient visits Shi L. et al. Diabetes Care 2013;36:

CONCLUSIONS Achieving both HbA1c and LDL-C goals in diabetes care is associated with additional clinical and economic benefits, compared with the achieving either goal alone Shi L. et al. Diabetes Care 2013;36: