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Short Reports

Physicians' Practices in Screening for the Development of Diabetic Nephropathy and the Use of Glycosylated Hemoglobin Levels

  1. Karen L Miller, MD and
  2. Irl B Hirsch, MD
  1. Department of Medicine and Division of Metabolism, Endocrinology, and Nutrition, University of Washington School of Medicine Seattle, Washington
  1. Address correspondence and reprint requests to Irl B. Hirsch, MD, University of Washington Medical Center, 1959 NE Pacific St., RC-99, Seattle, WA 98195.
Diabetes Care 1994 Dec; 17(12): 1495-1497. https://doi.org/10.2337/diacare.17.12.1495
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Abstract

OBJECTIVE To compare outpatient screening of diabetic patients for nephropathy and measurement of glycosylated hemoglobin (GHb) levels to published American Diabetes Association (ADA) guidelines.

RESEARCH DESIGN AND METHODS We reviewed charts from 157 diabetic patients followed for 27 months at the University of Washington's primary care clinics. The number of screening urinalyses, 24-h urine measurements, and GHb measurements were obtained. From these values, the frequency of screening tests, normalized by patient-year, could be compared with the ADA guidelines.

RESULTS Forty-two percent of the patients received at least one urinalysis, and 5% had 24-h urine measurements. There were 0.48 urinalyses and 0.05 24-h urine measurements per patient-year. Of 14 type I diabetes patients, 5 had a urinalysis and 1 received a 24-h urine measurement. At least one GHb was measured for 85% of patients, and there were 1.66 GHb measurements per patient-year. Only 29% of patients received GHb concentrations as recommended by ADA guidelines.

CONCLUSIONS Diabetic patients at this institution are not screened for nephropathy and do not receive GHb measurements according to the ADA guidelines. Because of recent advancements in the treatment of diabetic nephropathy and the results of the Diabetes Control and Complications Trial (DCCT), further efforts are needed for educating primary care physicians about standards of care of patients with diabetes.

  • Received July 20, 1993.
  • Revision received July 7, 1994.
  • Accepted July 7, 1994.
  • Copyright © 1994 by the American Diabetes Association

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December 1994, 17(12)
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Physicians' Practices in Screening for the Development of Diabetic Nephropathy and the Use of Glycosylated Hemoglobin Levels
Karen L Miller, Irl B Hirsch
Diabetes Care Dec 1994, 17 (12) 1495-1497; DOI: 10.2337/diacare.17.12.1495

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Physicians' Practices in Screening for the Development of Diabetic Nephropathy and the Use of Glycosylated Hemoglobin Levels
Karen L Miller, Irl B Hirsch
Diabetes Care Dec 1994, 17 (12) 1495-1497; DOI: 10.2337/diacare.17.12.1495
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