Testing for blood glucose by office-based physicians in the U.S.

A national sample of 2879 physicians were surveyed to ascertain characteristics of patient visits for diabetes including whether any test had been ordered or provided or a specimen taken to assess the patient's blood glucose level. Based on survey data, an estimated 21.3 million visits were made for diabetes in 1985. Of these, 16.8 million were for continuing care of diabetes by primary-care physicians, an average of 2.7 visits/yr for the 6.1 million U.S. residents diagnosed as having diabetes. A test for blood glucose was associated with 69% of these visits, an average of 1.9 times/yr per patient with diabetes in the U.S. Rates of testing for blood glucose varied by source of payment for the visit and were higher when diabetes was the primary diagnosis and when the number of physicians practicing together was greater, such as in health maintenance organizations or group practices. Rates of testing did not differ by age, race, or sex of the patient; location of the physician's practice; whether insulin or oral agents were prescribed; or a number of other characteristics. Other studies indicate that self-monitoring of blood glucose is performed by less than 10% of diabetic patients. Hence, the physician's office remains an important location for assessment of diabetes control by measurement of blood glucose levels.