The Effect of Changing Regular Care Provider in Type 2 Diabetes Mellitus: A Retrospective Study

• Published in: Acta medica portuguesa Vol. 32; no. 9; pp. 580 - 587
• Main Authors: Sousa Santos, Francisco, Tavares Bello, Carlos, Roque, Catarina, Capitão, Ricardo, Castro Fonseca, Ricardo, Limbert, Clotilde, Sequeira Duarte, João, Oliveira, Manuela, Vasconcelos, Carlos
• Format: Journal Article
• Language: English
• Published: Portugal Ordem dos Médicos 02-09-2019
• Subjects: Aged; Blood Pressure; Blood Pressure Determination; Body Mass Index; Case-Control Studies; Cholesterol, LDL - blood; Continuity of Patient Care; Diabetes Complications; Diabetes Mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Female; Glycated Hemoglobin A - analysis; Humans; Male; Patient Care Team; Patient Handoff; Physician-Patient Relations; Retrospective Studies; Time Factors; Transitional Care; Type 2; Patient Care Team; Diabetes Mellitus, Type 2; Diabetes Complications; Continuity of Patient Care
• ISSN: 0870-399X; 1646-0758
• DOI: 10.20344/amp.11304

Several studies have demonstrated the benefits of having a regular care provider on the control of chronic diseases. Our study intends to clarify the effects of the transition to a new diabetologist on metabolic control in type 2 diabetes patients followed-upin a tertiary care setting.
Retrospective study performed in an endocrinology outpatient clinic. We randomly selected 50 type 2 diabetespatients for a control group and 50 for a study group. In the study group, we registered the last evaluation before the physician change (year 0) and at the end of each year (year 1, 2 and 3) with the new doctor. Evaluated variables - body mass index, blood pressure, HbA1c and lipid profile - were compared yearly between groups.
There was a decrease in mean HbA1c levels (0.4% - 0.5%, p < 0.05) in year 1 and 2 when compared to year 0 in the study group, but not in the control group. This reduction was superior (0.5% - 1.4%, p < 0.05) in patients whose baseline HbA1c was greater than 7%. The other studied variables did not vary significantly throughout follow-up in either group.
In our study the transition to a different type 2 diabetes physician was associated with a decrease in mean HbA1c and this difference was greater in less well controlled patients.
Switching to a new physician may not be harmful and may actually have benefits for the glycemic control of some type 2 diabetes patients.