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Quality of Diabetes Care in the USA

  • Diabetes and Cardiovascular Disease (D Bruemmer, Section Editor)
  • Published:
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Abstract

Purpose of Review

The purpose of this review is to provide an overview of the current quality of diabetes care in the USA, discuss barriers to guideline-recommended treatment adherence, and outline strategies for the improvement in care.

Recent Findings

Current treatment guidelines highlight the importance of glycemic control, use of novel medications with proven cardiovascular efficacy, and multifactorial cardiovascular risk factor intervention for the treatment of diabetes and associated complications. Albeit proven evidence for these guidelines, the vast majority of patients with diabetes remain insufficiently treated. Interventions to improve outcomes require focus on care delivery systems, physician behavior, and patient-centered approaches. De-fragmenting care systems to form collaborative, multi-specialty teams, use of standardized and comprehensive treatment algorithms, development of quality assessment tools, avoiding physician therapeutic inertia, and addressing patient barriers, including lack of perceived benefit, insufficient diabetes education and access to care, and medication costs, represent key objectives to improve diabetes care and outcomes.

Summary

Clinical research in standardized trials has proven the feasibility to reduce morbidity and mortality associated with diabetes. Implementing models of care to disseminate these encouraging research findings to the wider population and to overcome barriers to achieving guideline-recommended treatment goals should be the objective to improve our current quality of diabetes care in the USA.

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Abbreviations

ACE:

Angiotensin-converting enzyme

ASCVD:

Atherosclerotic cardiovascular disease

CVD:

Cardiovascular disease

DSMES :

Diabetes self-management education and support strategies

GLP1-RA :

Glucagon-like peptide-1 receptor agonist

HbA1c:

Hemoglobin A1c

LDL:

Low-density lipoprotein

SGLT2:

Sodium-glucose co-transporter-2

T2DM :

Type 2 diabetes

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  1. Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA

    Ben Alencherry & Dennis Bruemmer

  2. Center for Cardiometabolic Health, Section of Preventive Cardiology and Rehabilitation, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue JB-815, Cleveland, OH, 44195, USA

    Dennis Bruemmer

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Alencherry, B., Bruemmer, D. Quality of Diabetes Care in the USA. Curr Cardiol Rep 23, 73 (2021). https://doi.org/10.1007/s11886-021-01503-5

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