--- title: "Initiation of tx for incident diabetes: EHRs in primary care | Sutter Health" description: "Among insured patients who have a primary care provider in a multispecialty health care system, incident diabetes is treated only half the time. Improved algorithms for identifying incident diabetes from the EHR and team approach for monitoring may help treatment initiation." url: "https://www.sutterhealth.org/research/publications/initiation-tx-incident-diabetes-ehrs-primary-care-1055312897" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Initiation of tx for incident diabetes: EHRs in primary care # Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting. Chung S, Zhao B, Lauderdale D, Linde R, Stafford R, & Palaniappan L. _Prim Care Diabetes. 9(1):23-30. doi: 10.1016/j.pcd.2014.04.005. Epub 2014 May 5._ 2015-02-01 ## Abstract OBJECTIVE: We examined patterns and predictors of initiation of treatment for incident diabetes in an ambulatory care setting in the US. METHODS: Data were extracted from electronic health records (EHR) for active patients ≥ 35 years in a multispecialty, multiclinic ambulatory care organization with 1000 providers. New onset type 2 diabetes and subsequent treatment were identified using lab, diagnosis, medication prescription, and service use data. Time from the first evidence of diabetes until initial treatment, either medication or education/counseling, was examined using a Kaplan-Meier hazards curve. Potential predictors of initial treatment were examined using multinomial logistic models accounting for physician random effects. RESULTS: Of 2258 patients with incident diabetes, 55% received either medication or education/counseling (20% received both) during the first year. Of the treated patients, 68% received a treatment within the first four weeks, and 13% after initial 16 weeks. Strong positive predictors (P < 0.01) of combined treatment were younger age, higher fasting glucose at diagnosis, obesity, and visits with an endocrinologist. CONCLUSIONS: Among insured patients who have a primary care provider in a multispecialty health care system, incident diabetes is treated only half the time. Improved algorithms for identifying incident diabetes from the EHR and team approach for monitoring may help treatment initiation. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/24810147) ## Research topics - [Diabetes, Insulin Resistance and Metabolic Syndrome](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Diabetes%2C+Insulin+Resistance+and+Metabolic+Syndrome%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Nudging physicians and patients with autopend clinical decision support to improve diabetes management.](https://www.sutterhealth.org/research/publications/autopend-decision-spt-to-improve-dm-mgmt-1055312391) Panattoni L, Chan A, Yang Y, Olson C, Tai-Seale M. Am J Manag Care. 24(10):479-483. 2018 Oct 01 - Publication ### [CM-SHARE: Development, integration, and adoption of an electronic health record-linked digital health solution to support care for diabetes in primary care.](https://www.sutterhealth.org/research/publications/ehr-linked-app-to-support-diabetes-care-in-primary-care-1055312811) Jones JB, Liang S, Husby HM, Delatorre-Reimer JK, Mosser CA, Hudnut AG, Knobel K, MacDonald K, Yan XS. Clin Diabetes. 37(4):338-346. doi: 10.2337/cd18-0057. 2019 Oct 01 - Publication ### [Can secure patient-provider messaging improve diabetes care?](https://www.sutterhealth.org/research/publications/secure-pt-provider-messaging-improve-diabetes-care-1055312308) Chung S, Panattoni L, Chi J, Palaniappan L. Diabetes Care. pii: dc170140. doi: 10.2337/dc17-0140. \[Epub ahead of print\] 2017 Aug 14 - Publication ### [Impact of education on weight in newly diagnosed type 2 diabetes: every little bit helps.](https://www.sutterhealth.org/research/publications/education-impact-wt-diabetes-1055312810) Azar KM, Chung S, Wang EJ, Zhao B, Linde RB, Lederer J, Palaniappan LP. PLoS One. 10(6):e0129348. doi: 10.1371/journal.pone.0129348. eCollection 2015. 2015 Jun 08 - Publication ### [Pharmacist-led medication management program within a patient-centered medical home.](https://www.sutterhealth.org/research/publications/pharmacist-led-medication-management-in-pcmh-1055312959) Romanelli RJ, Leahy A, Jukes T, Ishisaka DY. Am J Health Syst Pharm. 72(6):453-9. doi: 10.2146/ajhp140487. 2015 Mar 15 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/initiation-tx-incident-diabetes-ehrs-primary-care-1055312897#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Initiation of tx for incident diabetes: EHRs in primary care"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/initiation-tx-incident-diabetes-ehrs-primary-care-1055312897#medicalscholarlyarticle","name":"Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.","headline":"Initiation of tx for incident diabetes: EHRs in primary care","abstract":"OBJECTIVE: We examined patterns and predictors of initiation of treatment for incident diabetes in an ambulatory care setting in the US. METHODS: Data were extracted from electronic health records (EHR) for active patients ≥ 35 years in a multispecialty, multiclinic ambulatory care organization with 1000 providers. New onset type 2 diabetes and subsequent treatment were identified using lab, diagnosis, medication prescription, and service use data. Time from the first evidence of diabetes until initial treatment, either medication or education/counseling, was examined using a Kaplan-Meier hazards curve. Potential predictors of initial treatment were examined using multinomial logistic models accounting for physician random effects. RESULTS: Of 2258 patients with incident diabetes, 55% received either medication or education/counseling (20% received both) during the first year. Of the treated patients, 68% received a treatment within the first four weeks, and 13% after initial 16 weeks. Strong positive predictors (P \u003c 0.01) of combined treatment were younger age, higher fasting glucose at diagnosis, obesity, and visits with an endocrinologist. CONCLUSIONS: Among insured patients who have a primary care provider in a multispecialty health care system, incident diabetes is treated only half the time. Improved algorithms for identifying incident diabetes from the EHR and team approach for monitoring may help treatment initiation.","description":"Among insured patients who have a primary care provider in a multispecialty health care system, incident diabetes is treated only half the time. 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