Clinic Attendance and Glycemic Control: Study of Contrasting Groups of Patients With IDDM

Abstract

Objective: To assess factors associated with attendance at a specialized clinic for diabetes care. Research Design and Methods: Adults with insulin-dependent diabetes mellitus (IDDM) in poor (HbA1 ≥ to 12%) versus good (HbA1 ≤ 10%) control and with no known complications comprised the study group. Results: Infrequent attenders were in worse glycemic control than regular attenders (χ 2 = 6.60, P ≤ 0.01) and held health beliefs that downplayed the importance of getting advice from physicians (P ≤ 0.002) or providing opinions to physicians about what might be done to improve their health (P ≤ 0.001). Conclusions: Because infrequent attenders are more likely to be in poor glycemic control and thus at greater risk for diabetic complications, engaging them in regularly supervised treatment has important personal and public health implications. Additional studies are needed to understand why some diabetic patients limit their contact with medical providers and to develop more effective strategies for reversing this process. Initial findings from this study suggest that patient beliefs about the doctor-patient relationship may influence clinic attendance.