Use of a diabetes registry to identify risk factors for long-term morbidity and mortality among diabetic patients in San Antonio, Texas

Introduction. The San Antonio Diabetes Registry Pilot Project is an electronic registry that tracks the reported values of glycohemoglobin (HbA1c) for over 200,000 unduplicated patients. Coordinated by the San Antonio Metropolitan Health District, this pilot project aims to characterize the prevalence of poor glucose control (i.e., elevated % HbA1c) in this community where the burden of diabetes mortality and morbidity is significant, especially among the population < 65 years of age. Methods. Data for this assessment were provided by four clinical laboratories in San Antonio, Texas. Median HbA1c values of individuals 19-64 years of age who had been referred to these laboratories for an HbA1c test were compared to HbA1c data from the 1999-2006 National Health and Nutrition Examination Survey (NHANES). These data were further examined for geographic disparities. Results. We found that the overall median (6.5%) and gender-specific medians of HbA1c (females, 6.5%; males, 6.7%) were lower than both national preventive health recommendation of <7.0% and the median % HbA1c for the NHANES cohort. However, we observed geographic disparities of elevated % HbA1c test values (e.g., >7.0%) as well as geographic disparities of those who have not received the HbA1c test within the recommended 120 days. Conclusion. The San Antonio Diabetes Registry will provide valuable information regarding disparities of HbA1c values as well as the use of HbA1c testing in this community. It may also foster the development of public health capacity needed to identify additional risk factors that contribute to excessive diabetes-related morbidity and mortality in this community.