The United States states that expanded their Medicaid programs with the Health System Reform Law registered a greater growth of diabetes cases than the rest of the states.
This, for the authors of a new study, suggests that this expansion of Medicaid coverage favors the earliest diagnosis of the disease, which will improve the therapeutic results.
The researchers used the laboratory tests recorded in the Quest Diagnostics database, which includes about 150 million annual controls, to determine how many patients had been performed at least one A1C hemoglobin test that was normal before the medical expansionand increased with expansion.
The team of Dr. Harvey Kaufman, Senior Medical Director of Quest Diagnostics, who financed the study, publishes in Diabetes Care that 26 states expanded access to Medicaid.
In the jurisdictions with more income, the detection of new cases of diabetes grew by 23 percent (from 14,625 in the first half of 2013 to 18,020 in the same period of2014), while in the states without that expansion of coverage, theDetection improved just 0.4 percent.
And the average A1C values of these two groups were, respectively, 7.96 and 8.14 percent.
"It is evident in the states that did not expand the coverage that the diagnosis is later, when patients reach hospitals with complications," said Dr. Robert Ratner, scientific director and doctor of the American Diabetes Association.
"The sooner the disease is detected, the simpler its treatment and the answer will be," said Ratner, who did not participate in the study.
While in the study there were more women than men with diabetes, the growth of diagnoses was greater in men.The same happened between the age of 50 and 64 versus between the ages of 19 and 49.
The study has some limitations, such as having used only the results of Quest Diagnostic blood glucose and not having clinical information.
In addition, it is possible that some of the patients evaluated in Quest had diagnosed the disease before the start of the study.
Therefore, "we do not know with 100 percent security if they were new diagnoses," said Dr. Benjamin Sommers, a health economist at the T.H. School of Public Health.Chan from Harvard, Boston, and did not participate in the study.
"But the design of the study makes a lot of sense. These results would be the tip of the iceberg and we could imagine the same results with the early detection of hypertension or cancer or mental illness," he added.
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