Introduction: Medical travel, a form of patient mobility across borders, has gained significant momentum in the last years. Nevertheless, limited evidence exists regarding the clinical outcomes for these patient-sought treatments at U.S. institutions. We aimed to examine the characteristics of global patients referred to our institution for short-term diabetes management and the impact of our consultation on the cohort’s glycemic control.
Methods: We identified adult patients with established diabetes mellitus, who sought medical care at the Cleveland Clinic Foundation between the years 2010 and 2016 from the following countries: Bahrain, Qatar, UAE, Kuwait, Saudi Arabia and Oman, and were seen at least once by an endocrinology provider. Our control group included an internationally identical cohort with diabetes mellitus, but without an office visit to endocrinology. Continuous, normally distributed data were described using means and standard deviations (SD), while non-normally distributed data were described using medians and quartiles. To assess the impact of our endocrine consultations, changes in HbA1C were assessed after single and multiple endocrine visits using paired t-tests.
Results: Our study included 1,1subjects (771 in study group, 337 in control group), with a mean age (±SD) of 61.3±12.7 years, 62% male, and a median follow-up duration of 136 days [IQR: 57, 660]. Compared to controls, study subjects had higher baseline mean HbA1C level (8.0±1.8% vs. 7.1±1.4%, p<0.001) and higher prevalence of cardiovascular disease (64.6% vs. 56.0%, p=0.006). After only one visit with endocrinology, there was a significant decrease in mean HbA1C of -1.00% (95% CI:-1.23, -0.78) (p<0.001). The greatest degrees of change in mean HbA1C were -1.47% (95% CI: -2.21, -0.74) and -1.27% (95% CI: -1.89, -0.66) after 3 and 4 visits, respectively (p<0.001).
Conclusion: Global patients seen for diabetes management had a significant drop of nearly 1 point in HbA1c even after one endocrinology consultation.
K.F. Ali: None. A. Mikhael: None. C. Zayouna: None. M. Lansang: None.