Suboptimal diabetes screening in RA patients
medwireNews: Adherence to diabetes screening guidelines is suboptimal among patients with rheumatoid arthritis (RA), Canadian study results suggest.
“Rheumatoid arthritis is associated with a substantial increase in the risk of cardiovascular events,” and individuals with RA “may also have an increased risk of developing [diabetes],” an important risk factor for cardiovascular disease (CVD), say Diane Lacaille (Milan Ilich Arthritis Research Centre, Richmond, British Columbia) and colleagues.
“General population guidelines, which recommend screening every 3 years after age 45, represent the minimum standard of care for [diabetes] screening and CVD prevention in RA,” they add.
The researchers used administrative health records to analyze data from 22,624 patients with RA who were treated in British Columbia in 1996–2006 and followed up until 2010, and 22,579 general population controls matched on age, sex, and year of study entry.
As reported in The Journal of Rheumatology, the team found that RA patients had plasma glucose tests in 71.4% of their eligible periods, on average, compared with 70.6% for their non-RA counterparts.
These findings translate into a significant 5% higher likelihood of adhering to screening recommendations among RA patients compared with controls after adjustment for factors including age, sex, and comorbidities, but the researchers stress that the absolute difference in rates between the two groups was small, and that “the clinical relevance of this difference is unclear.”
Moreover, 15.0% of RA patients and 17.1% of control individuals did not receive a plasma glucose test in any eligible period, and only 56.9% and 55.1%, respectively, underwent testing in all of their eligible periods.
These findings “represent an important deficiency in the care provided to people with RA,” and “emphasize the need to raise awareness about the increased risk of CVD and of [diabetes]” in these patients, say Lacaille and colleagues.
And the team concludes: “CVD prevention efforts in RA should involve [primary care providers], because they order most of the glucose tests and they play a central role in primary prevention care.”
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