Internal medicine journal · 2025
Evaluating diabetes care processes, comorbidity burden and continuous glucose monitoring utilisation in regional Australia: results from Central Queensland Hospital.
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Rana Arushi, Syed Aatif, Rauf Amal, Gupta Rajat, Lim Francesca, Konantambigi Akash, Weich Belinda, Abbood Majid-Al, Hayward Marion, Malabu Usman, Shenoy Vasant, Deshmukh Harshal
Аннотация
BACKGROUND AND AIMS: Real-world adherence to guideline-recommended diabetes care in regional Australia is poorly described. This study aimed to evaluate adherence to diabetes care processes, comorbidity burden and continuous glucose monitoring (CGM) metrics among individuals with type 1 diabetes (T1D) attending a regional hospital in Central Queensland, Australia.
RESEARCH DESIGN AND METHODS: A retrospective audit of 175 patients with T1D was conducted using electronic medical records. Data on demographics, care process adherence, comorbidities and CGM metrics were analysed. A gradient boosting machine (GBM) model assessed factors influencing glycaemic control.
RESULTS: The cohort had a mean age of 40.4 years and a diabetes duration of 18.5 years. Most were Caucasian (92.5%), with 7.5% identifying as First Nations Australians. Obesity prevalence was 32%, and 17.9% of patients were current smokers. Mean hemoglobin A1c was 8.51%, indicating suboptimal glycaemic control. Adherence to screening protocols varied: blood pressure monitoring (79.8%), lipid profile screening (68.8%), kidney function assessment (89.7%), retinopathy screening (43.8%) and foot examinations (28.4%). CGM usage was high (77.8%), with an average of 14 scans per day. CGM metrics showed a mean time in range of 42.9%, time above range of 54.2% and a glucose management indicator of 7.99%. The GBM model identified body mass index as the strongest modifiable factor influencing glycaemic control.
CONCLUSIONS: Despite high CGM adoption, glycaemic control remains suboptimal and significant gaps exist in essential care processes, particularly retinal and foot screenings. These findings highlight the need for targeted interventions to improve diabetes management in regional Australian settings.
RESEARCH DESIGN AND METHODS: A retrospective audit of 175 patients with T1D was conducted using electronic medical records. Data on demographics, care process adherence, comorbidities and CGM metrics were analysed. A gradient boosting machine (GBM) model assessed factors influencing glycaemic control.
RESULTS: The cohort had a mean age of 40.4 years and a diabetes duration of 18.5 years. Most were Caucasian (92.5%), with 7.5% identifying as First Nations Australians. Obesity prevalence was 32%, and 17.9% of patients were current smokers. Mean hemoglobin A1c was 8.51%, indicating suboptimal glycaemic control. Adherence to screening protocols varied: blood pressure monitoring (79.8%), lipid profile screening (68.8%), kidney function assessment (89.7%), retinopathy screening (43.8%) and foot examinations (28.4%). CGM usage was high (77.8%), with an average of 14 scans per day. CGM metrics showed a mean time in range of 42.9%, time above range of 54.2% and a glucose management indicator of 7.99%. The GBM model identified body mass index as the strongest modifiable factor influencing glycaemic control.
CONCLUSIONS: Despite high CGM adoption, glycaemic control remains suboptimal and significant gaps exist in essential care processes, particularly retinal and foot screenings. These findings highlight the need for targeted interventions to improve diabetes management in regional Australian settings.