Despite having an increased risk for diabetes and cardiovascular disease (CVD), patients with rheumatoid arthritis (RA) have suboptimal rates of compliance with guidelines for diabetes screening, with little difference compared with the general population, according to results published online in The Journal of Rheumatology.

The study included all cases of RA in British Columbia between 1996 and 2006 (n=22,634) and general population controls (n=22,579) and participants were followed until 2010. The researchers used administrative data to measure compliance with general population diabetes screening guidelines, excluding participants with previous diabetes. They measured compliance as the percentage of 3-year eligibility follow-up periods with ≥1 plasma glucose test performed. They calculated the odds ratio (OR) of compliance in participants with RA compared with the general population using generalized estimating equation models, adjusting for age and sex.

In total, participants with RA contributed 48,724 eligibility periods and controls contributed 51,081 eligibility periods.


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In participants with RA, plasma glucose was measured in 72.3% of the eligible time periods compared with 70.4% in the general population (OR, 1.05; 95% CI 1.02–1.09; P <.0001). Participants with RA met recommended screening guidelines in 71.4% of the eligible periods compared with 70.6% in the general population.

The researchers identified several significant predictors of not receiving diabetes screening in participants with RA, including being male, having a higher socioeconomic status, having more comorbidities, seeing a rheumatologist in the past 5 years, and having no physician visits in the past year.

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“Our study findings emphasize the need to raise awareness about the increased risk of CVD and of [diabetes] in RA, and of the importance of [cardiovascular] risk management, including screening for [diabetes],” the researchers wrote. “CVD prevention efforts in RA should involve [primary care clinicians], because they order most of the glucose tests and they play a central role in primary prevention care.”

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Reference

Schmidt TJ, Aviña-Zubieta JA, Sayre EC, et al. Cardiovascular disease prevention in rheumatoid arthritis: compliance with diabetes screening guidelines [published online July 15, 2018]. J Rheumatol. doi:10.3899/jrheum.170973