ArticleMissouri medicine
Comparison of Family Medicine and General Internal Medicine on Diabetes Management.
Article in Missouri medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 10 citations in OpenAlex.
- Inequity, workload, and external factors: a descriptive study on high-intensity statin prescriptions for patients with clinical cardiovascular disease and at high risk for cardiovascular disease.BMC cardiovascular disorders · 2025Article
- Intangible cost and its associated factors among caregivers of individuals with Type 2 Diabetes Mellitus managed at primary healthcare settings: a scoping review.BMC health services research · 2025Article
- Unravelling the obesity maze in diabetic patients: A comparative analysis of classification methods.Journal of family medicine and primary care · 2024Article
- Long-term remission of type 2 diabetes through intense lifestyle modification program - A case series.Journal of family medicine and primary care · 2023Article
- Association Between HEDIS Performance and Primary Care Physician Age, Group Affiliation, Training, and Participation in ACA Exchanges.Journal of general internal medicine · 2020Observational
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The majority of patients with type 2 diabetes are managed in primary care, either in family medicine (FM) or general internal medicine (GIM). Variances in training, beliefs and practice decisions between FM and GIM may result in differing approaches to diabetes management. This study found that differences do exist in the choice of treatment by FM vs GIM; however, these differences are driven by patient characteristics and does not result in glycemic control disparities. BACKGROUND AND
objectivesApproach to management of chronic health conditions differs between family medicine (FM) and general internal medicine (GIM). Differences might be due to beliefs, patient case mix, training, and/or experience. This study determined if FM and GIM diabetes management differences exist, and if so, resulted in better or worse glycemic control.
methodElectronic medical record data from 2008-2013 were used to identify 976 patients (287 FM and 689 GIM) with type 2 diabetes and prescriptions for metformin. GEE-type regression models were computed to control for repeated measures and estimate the association between primary care specialty and glycemic control, defined as percent of patients with HgA1c<8.5 and average HgA1c. Covariates included demographics, comorbidities, smoking and health care utilization, and diabetes treatment.
resultsCompared to FM patients, significantly more GIM patients received a non-metformin medication (35.9% vs 47.2%) and insulin (16.4% vs 23.8%). After adjusting for covariates, FM patients had significantly lower HgA1c values (B = -.47; 95% CI: -0.68, -0.27) and were less likely to have an HgA1c>8.5 (OR=0.55; 95%CI:0.40-0.77). FM vs GIM patients did not differ in degree of HgA1c improvement over time.
conclusionsFM patients vs GIM patients are less likely to receive a non-metformin and insulin medication. Differences in diabetes management likely correspond to degree of HgA1c control. Choice of treatment appears to reflect patient needs as both FM and GIM patients experienced equal improvement in HgA1c. Primary care specialty differences in beliefs and practices around diabetes management do not result in disparities in patient care.
Indexed as
Identifiers
30228578PMC6140227W3024393692What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.