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Capstone

Management of type 2 diabetes: Chronic care management in an acute care setting

1 August 2001

Abstract

The purpose of this study is to determine if type 2 diabetes managed in an acute care setting is adequately meeting the diverse needs of the diabetic population by adhering to the established American Diabetic Association (ADA) guidelines.

The study is a retrospective chart review of 328 type 2 diabetic patients at West Suburban Internists (WSl) located in Wheaton, Illinois. Since the study population includes all type 2 diabetic patients at the practice, no random selection was necessary. The study population consisted of 139 females and 189 males. The average age of the females was 64 years while the average age of the males was 63 years. Of the 328 patients studied, 40 of them were seen at a pilot diabetes management clinic established one year prior to the data collection.

The results indicated that adherence to the ADA guidelines was well below 50% in the majority of categories analyzed. Furthermore, there were significant differences between the outcomes of patients seen in the established clinic compared to the overall WSI study population. The clinic outcomes were more favorable in 13 out of the 16 categories compared.

The preliminary results are significant because the clinic participants were exposed to a chronic care management philosophy while the non-clinic patients were exposed to the standard acute care setting and philosophy.

The preliminary conclusion based on the results is that the predominant acute care setting approach is failing to meet the needs of the majority of type 2 diabetic patients. Serious thought and consideration should be given to redesigning the current system to emphasize a chronic care model of disease management for type 2 diabetes instead of the inefficient acute care model.


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