Diabetes Management in The King County Correctional Facility (KCCF): A retrospective chart review to assess characteristics of patients with diabetes and provision of care

Background: In any given year approximately 80,000 individuals with diabetes are incarcerated in the United States. However, diabetes care protocols and outcomes within correctional settings are understudied.

Methods: We conducted a retrospective chart review for patients with diabetes who were admitted to King County Correctional Facility (KCCF) in Seattle in 2012 and had a length of stay greater than 72 hours. We randomly selected charts based on medical record numbers and collected data on patients’ physical health, treatment at intake, opportunity to see a provider, level of diabetes management, and re-booking. We performed bivariate and multivariable analysis to assess if patient characteristics were associated with health outcomes and compared these results to a similar study conducted in the San Francisco County Jail in 2003. 

Results: We found high rates of compliance with KCCF diabetes protocols, but no statistically significant effect on long-term patient health. Patients’ glucose levels stabilized during their incarceration but returned to unstable levels after release. The population entering KCCF has significantly higher rates of hypertension and lower blood glucose management (as measured by HbA1c levels) than the population booked in San Francisco. 

Conclusions: KCCF successfully meets its clinical protocols for diabetes care, but these protocols are not contributing to better health outcomes for patients. This population might benefit from release planning and a stronger continuum of care between Jail Health Services and outside providers.