All those times when your diabetologist told you that regular follow-ups are the key to your good health, if you had asked her to show you proof, rest assured she’d have been stumped. Not any longer though.
A paper published in the recent issue of Acta Diabetol has provided proof, probably for the first time, that regularity of consultant visits has a definite beneficial effect on the patient. The paper by R.M. Anjana et al, aims to show that regular visits to the doctor meant complications, especially nephropathy and retinopathy, tended to occur much later.
A total of 3,581 patients with Type 2 Diabetes were followed up between 2003 and 2012, of which roughly half were ‘regular’ patients. Regular was classified as a minimum of three visits and two HbA1c annually, and irregular as two visits or less and one HbA1c test or less in a year, Dr. Anjana said.
“What we’ve done is calculate the glycaemic burden (using an existing formula) using the HbA1c score of the individual, over a period of time. And, we asked the questions: Does this have an impact on diabetes-related complications? Can it be influenced by regular visits to the doctor?” she said.
The answers provided empirical evidence in favour of regular follow-ups. “In the ‘regular’ group, patients had a lower rate of complications of retinopathy and nephropathy – these have the strongest association with diabetes,” she added.
Patients accumulate glycaemic burden not only through clinical inertia at the physician’s level, but also on account of irregular follow-ups on the part of the patient, said V. Mohan, co-author, and chief of Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, where the patients came from. “The clear message is that the physician can intervene quickly enough if patients make regular visits to the doctor,” he added.
“You may say, we are saying this because we run a hospital, that making regular visits costs money, but it actually makes better economic sense if you keep your appointments,” Dr. Anjana said. The study showed the mean additional cost incurred for regular follow-ups was Rs. 1,455 per patient per year, which is considerably lower than the potential cost of treating complications, she added.
