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Follow‐up frequency and clinical outcomes in patients with type 2 diabetes: A prospective analysis based on multicenter real‐world data
Authors:Qiubo Zhao  Hongwei Li  Qicheng Ni  Yuancheng Dai  Qidong Zheng  Yufan Wang  Tingyu Ke  Li Li  Dong Zhao  Qijuan Dong  Bangqun Ji  Juan Shi  Ying Peng  Yifei Zhang  Fengmei Xu  Weiqing Wang
Abstract:BackgroundTo determine whether the follow‐up frequency for type 2 diabetes mellitus (T2DM) patients in the National Metabolic Management Centers (MMCs) leads to different clinical outcomes.MethodsA total of 19 908 T2DM patients with at least 6 months of facility‐based follow‐up were recruited in MMCs between June 2017 and April 2021 and divided into lower‐frequency and higher‐frequency follow‐up (LFF and HFF) groups according to the median follow‐up frequency of 2.0 (interquartile range 1.2) times per year. Metabolic parameters at baseline and at the last follow‐up visit were analyzed. Multivariable linear regression models were performed to assess the relationship between follow‐up frequency and between‐group percentage changes, adjusting for the major covariables. Additional stratified analyses were conducted to evaluate the metabolic outcomes in the subgroups.ResultsThe characteristics of the participants in the LFF and HFF groups were significantly different at baseline. Participants had significant improvements in multiple metabolic parameters after follow‐up. Patients with HFF showed significantly greater decrease in percentage changes of fasting blood glucose (−4.95% ± 37.96% vs −2.21% ± 43.08%, P < .0001) and glycosylated hemoglobin (HbA1c) (−12.14% ± 19.78% vs −9.67% ± 20.29%, P < .0001) after adjustments compared to those with LFF. Furthermore, stratification analyses showed that significant between‐group percentage changes of HbA1c were observed in those with younger age (<55 years) and higher HbA1c (>9%) at baseline (P for interaction <.001).ConclusionsHFF is associated with better metabolic outcomes. Participants, especially with younger age or worse HbA1c at baseline in the HFF group achieved better glycemic control than those in the LFF group.
Keywords:cost‐  effectiveness  follow‐  up frequency  glycemic control  type 2 diabetes mellitus
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