Mean HbA1c Comparison among Diabetic Subgroups Treated with Oral Agents alone, Insulin alone and Combination of Both

Purpose: The goal of the paper is to determine if there is a significant difference in mean Hemoglobin A1c (a1c) among treatment-groups comprising Type 2 Diabetes patients receiving oral hypoglycemic agents alone, insulin alone, and a combination of oral agents and insulin, respectively. Methods: Deidentified patient data were obtained from an ambulatory clinic EHR over a 5-year period, 2011-2015, representing a1c results of all active patients on either oral hypoglycemics, insulin, or both. The latter of at least two a1c results from the preceding 12 months in qualifying patients was used. Age and Gender data were collected for patient distribution comparisons among the groups. Results: Of 3058 records, oral treatment group numbered 2084 or 68% of the total population; insulin group was 160 (5%) and combination treatment group was 814 or 27% of the population. Age and gender distribution were similar in all groups. There were statistically significant differences at 95% CL between the group means: 7.9, 8.9 and 9.3 for oral, Insulin and Oral+Insulin respectively, with p-values of Oral- Insulin P=3.80e-10; Oral- Oral+Insulin P <2.2e-16; and Insulin- Oral+Insulin P=0.0013. Conclusions: Oral treatment group had the lowest mean a1c (statistically different) and the highest percent of patients with a1c under 8%, followed by Insulin group in both categories, then, combination group