1114-P: Management Outcomes by Provider Type in People with Diabetes Receiving Care at a Federally Qualified Health Center

Introduction: Federally Qualified Health Centers (FQHCs) provide crucial health services to medically underserved populations. While primary care has been shown to improve outcomes in people with diabetes, comprehensive care from a multidisciplinary team of endocrinologists and other diabetes care specialists can optimize management outcomes.

Objectives: Examine differences in management outcomes by provider type using data from an FQHC offering a recently established Diabetes Specialty Care service to people with diabetes in San Diego, CA.

Methods: t-tests and linear regressions models.

Results: Of N = 35,092 adults with diabetes seen between 2017-2022, 7% were seen by an endocrinologist. Compared to patients only seen by a primary care provider (PCP), patients receiving diabetes care from an endocrinologist had higher A1C (M=8.9% vs. M=7.8%; p < 0.001) and lower systolic blood pressure (M=108 mmHg vs. M=114 mmHg; p < 0.001), and higher prescription rates of metformin (55% vs 52%, p < 0.01), insulin (25% vs 22%, p < 0.01), sulfonylureas and meglitinides (24% vs 22%, p = .005), and continuous glucose monitors (CGM) (54% vs 10%, p < .0001). After controlling for age, sex, race, education, and provider type, patients seen by an endocrinologist had 17% increased odds of metformin (p = .0005) and insulin (p = .0009) prescriptions, 14% increased odds of sulfonylurea and meglitinide prescriptions (p = .010), and 1699% increased odds of CGM (p = <.0001) compared to patients seen by a PCP. While not significant (p’s > .05), there were more patients seen by an endocrinologist who were prescribed SGLT2i (9% vs 8%), GLP-1 RA (11% vs 10%), and DPP-4i (15% vs 13%).

Conclusion: Higher prescription rates of diabetes medications and technology were observed in patients seen by an endocrinologist at an FQHC. These findings emphasize the importance of integrating endocrinologists and other diabetes specialty care services into FQHCs, where many vulnerable people with diabetes receive care.