Concurrent Control of Blood Glucose, Body Mass, and Blood Pressure in Patients With Type 2 Diabetes: An Analysis of Data From Electronic Medical Records

Objective: This cross-sectional study describes glycemic, body mass, and blood pressure (BP) control in patients with type 2 diabetes mellitus (T2DM) in an ambulatory care-based database of electronic medical records (EMRs). Methods: Patients aged ≥18 years with T2DM documented in 2008 and with glycosylated hemoglobin (HbA_1c) value, body mass index (BMI), and BP charted within 90 days before or after T2DM documentation were identified using the General Electric Centricity EMR research database. Control of glycemia (controlled, <7.0%; uncontrolled, ≥7.0% [intermediate, 7.0%- <9.0%; poor, ≥9.0%]), body mass (nonobese, <30 kg/ m²; obese, ≥30 kg/m² [intermediate, 30-<35 kg/m²; poor, ≥35 kg/m²]), and BP (controlled, <130/<80 mm Hg; uncontrolled, ≥130/≥80 mm Hg [intermediate, 130-<160/80-<100 mm Hg; poor, ≥160/≥100 mm Hg]) was identified, and patients were stratified by level of control individually and in combination. Comorbidities and antidiabetic and antihypertensive treatments prescribed in the year before the index date were identified in the EMR. Results: The mean (SD) age of the cohort (N = 49,560) was 60.9 (12.4) years; 51.5% were female. A minority had controlled glycemia (36.4%), body mass (30.2%), and/or BP (36.4%). Of those with controlled glycemia and body mass, 44.8% also had controlled BP, representing 5.5% of the overall study population. Conclusions: Despite the potential selection bias, a minority of patients in this cross-sectional study were at HbA_1c, BP, or BMI goals, and even fewer gained control of all 3 of these risk factors. More intensive T2DM treatment with complementary efforts to manage body mass and BP is warranted in this population.