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Adherence to Diabetic Hypercholesterolemia Management Guidelines at a Rural Internal Medicine Clinic

1 August 2004


Background: Clinical trials have demonstrated significant benefit from serum cholesterol management for patients with diabetes. This study evaluated the degree of adherence to current American Diabetic Association (ADA) and National Cholesterol Education Program (NCEP) diabetic hypercholesterolemia management guidelines at Valley Medical Clinic, a rural internal medicine clinic located in Baker City, OR.

Methods: This study involved a retrospective chart review of 120 diabetic patients selected at random Patient demographics including age~ sex, ethnicity,.and diabetic type were recorded. Each patient's most current lipid profile was reviewed and their LDL-C was recorded. The use of diet, exercise, and pharmacological agents was also recorded.

Results: 43% of patients had an LDL-C of < 100 mg/dl while 76% had an LDL-C < 130 mg/d~ comparing favorably with published data. Furthermore, the average LDL-C of all patients was 110 mg/dI, approaching the recommended goal. There was no clear age difference among groups although it appeared male patients were being more aggressively treated than female patients. '

Conclusions: Most patients with diabetes at Valley Medical Clinic did not meet current national hypercholesterolemia guidelines for diabetes management. Increasing adherence to these guidelines should be a priority for the practice. The use of patient education, , checklists, flow sheets, or other tools may help. Valley Medical Clinic can improve clinical outcomes by adhering to current diabetic hypercholesterolemia management guidelines in their diabetic patients. ' ,


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