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The Management of Diabetes Mellitus Working Group (1999) VHA/DOD Clinical Practice Guideline for the Management of Diabetes in the Primary Care Setting.

has been cited by the following article:

  • TITLE: A Retrospective Observational Analysis of Clinical Outcomes before and after the Publication of the AACE/ACE Guidelines

    AUTHORS: Rajesh Peddaiahgari, Ayoade O. Adeyemi, Jamie C. Barner, Debra A. Lopez, Jason R. Jokerst

    KEYWORDS: AACE/ACE Guidelines, Type 2 Diabetes, Non-Insulin Antidiabetic Medications, HbA1c

    JOURNAL NAME: International Journal of Clinical Medicine, Vol.5 No.12, June 30, 2014

    ABSTRACT: Background: The influence of the American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) guidelines (hereafter, “guidelines”) on clinical outcomes of patients with diabetes is yet to be assessed. Objectives: To determine if differences occurred in type of: 1) medication class prescribed; 2) therapy by A1c strata in type 2 diabetic (T2DM) patients before and after guidelines were published (December 2009). Methods: Data for this retrospective cohort study were extracted from community health center clinics’ electronic medical records for patients who: 1) were adults (18 - 80 years) with T2DM; and 2) had at least one A1c value before and after guidelines. Demographic characteristics and clinical outcomes [oral anti-diabetic (OAD) medication class, therapy type (mono, dual, triple), and A1c values] were collected. A1c was stratified into four levels: 9.0. Descriptive and inferential statis-tics were used. Results: The random sample of 302 patients was 55.4 ± 11.7 years of age, primarily female (65.9%) and Hispanic (68.8%). Regarding medication class, most (68.5% before and 72.2% after guidelines) patients were prescribed metformin. The proportion of patients across individual medication classes increased significantly (p 9% were on dual therapy. After guidelines, 48.4% of patients with A1c values 9% were on dual therapy. Almost one-half (48.3%) of patients remained in the same A1c strata before and after guidelines were published and there were no significant changes in mean A1c. Conclusions: DPP-4 inhibitor use showed the largest increase after guidelines were issued, however, there were no improvements in A1c. Additional research is warranted to evaluate healthcare providers’ adherence to AACE/ACE guidelines and how this influences patients’ health outcomes.