Use of an electronic integral monitoring system for patients with diabetes to identify factors associated with an adequate glycemic goal and to measure quality of care.

Antonio-Villa, Neftali Eduardo; Palma-Moreno, B Geovani; Rodríguez-Dávila, Fátima M; Gómez-Pérez, Francisco J; Aguilar-Salinas, Carlos A; Hernández-Jiménez, Sergio; García-Ulloa, Ana Cristina; Almeda-Valdes, Paloma

AIMS To evaluate the use of the electronic integral monitoring system (SMID) to identify factors associated to glycemic control and its impact in the quality of care in patients with type 2 diabetes (T2D). METHODS T2D patients registered in SMID were analyzed. Biochemical, clinical and lifestyle variables were recorded. Factors associated to HbA1c ≤7% were explored. Quality of care of the clinic was measured according to the National Committee for Quality Assurance Criteria (NCQA) that requires a score of 75 to achieve a good quality of care. RESULTS 511 patients were included. Prescription of basal insulin, SGLT-2 inhibitors and barriers to follow nutritional plan were associated with decreased probability of having adequate glycemic control. Patients in the maintenance stage of motivation had higher probability of having HbA1c ≤7%. According to NCQA evaluation 60 points were achieved. Glucose goals were not met; 35.9% had HbA1c ≥9% and 17% HbA1c <7%. While foot evaluation, smoking approach, blood pressure and lipids goals were accomplished; eye and renal evaluations were borderline. CONCLUSION Glycemic control in patients with long standing T2D and multiple comorbidities is challenging, which directly impacts in the quality of care. Professionals should focus in reinforcing non-pharmacological interventions to optimize glycemic targets.