PS2-18: Characterization of the Health Care of Patients with Impaired Fasting Glucose Compared to Those with Normal Fasting Glucose Managed in a Rural Multi-Specialty Medical Group Practice.
ABSTRACT Background/Aims Patients with impaired fasting glucose (IFG) are at risk for developing diabetes and cardiovascular disease. The microvascular and macrovascular changes caused by diabetes often predate diabetes onset by years. Diabetes and its complications can be delayed and even prevented by lifestyle modification and medical therapy. The extent to which patients in our rural health care environment receive such proven care strategies remains unknown.The aim of this study was to compare IFG patients to normoglycemic patients in clinical characteristics, risk factors for vascular disease, and co-morbid conditions, and the frequency and rigor with which they were evaluated and treated in a rural healthcare multispecialty group medical practice in Central Pennsylvania. Methods A case-control study design was employed to address the aims of the study. Clinical data from patients treated at Geisinger Clinic between January 1, 2004 and August 31, 2009 were extracted from the Geisinger electronic health record and analyzed. Results A total of 19,684 IFG patients and 19,684 controls were included in the study population. Compared with normoglycemic patients, IFG patients were slightly older (50.3 years vs. 47.7 years) and had more co-morbid illnesses (1.5 vs. 0.9 co morbidities, p<0.0001). Despite this, IFG patients were evaluated only slightly more frequently for vascular disease, and risk factors for vascular disease were treated only slightly more rigorously than they were in normoglycemic patients with the vast majority of at risk patients remaining suboptimally treated for modifiable risk factors for vascular disease. Conclusions Despite impaired fasting glucose having been shown to be a marker for increased risk of type 2 diabetes and future cardiovascular disease, physicians in our rural multispecialty group practice do not appear to consistently discriminate between their management of patients with impaired fasting glucose and those with normoglycemia.