{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:46:51Z","timestamp":1785937611900,"version":"3.56.0"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,3,24]],"date-time":"2015-03-24T00:00:00Z","timestamp":1427155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of the present study was to explore features associated with glycemic control in type 2 diabetes (<jats:styled-content style=\"fixed-case\">T2D<\/jats:styled-content>) patients undergoing care by specialist clinics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Literature searches identified diabetes registries whose databases recorded outcomes of specialist care. The <jats:styled-content style=\"fixed-case\">LMC D<\/jats:styled-content>iabetes <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>egistry database (<jats:italic>n<\/jats:italic>\u2009=\u200958\u2009280; <jats:styled-content style=\"fixed-case\">LMC<\/jats:styled-content>) was queried to identify patients with <jats:styled-content style=\"fixed-case\">T2D<\/jats:styled-content> who had been seen in a defined 14\u2010month period. Logistic regression modeling was used to identify predictors of glycemic control in these patients. Poor glycemic control was defined as <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> \u22659.0% (75\u2009mmol\/mol) despite specialist care for \u22651 year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Few published registry\u2010based studies have discussed glycemic control and outcomes of specialist care for <jats:styled-content style=\"fixed-case\">T2D<\/jats:styled-content>. Among 10\u2009590 <jats:styled-content style=\"fixed-case\">LMC<\/jats:styled-content> patients with <jats:styled-content style=\"fixed-case\">T2D<\/jats:styled-content>, mean <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> was 7.6% (60\u2009mmol\/mol), with 38% of patients meeting the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>anadian <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>iabetes Association target of \u22647.0% (53\u2009mmol\/mol). Overall, 15% showed poor glycemic control with persistent <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> \u22659.0% (75\u2009mmol\/mol); among insulin\u2010treated patients (<jats:italic>n<\/jats:italic>\u2009=\u20093856), 28% met this criterion. Patient characteristics independently associated with poor glycemic control included early age of onset, the number of diabetes education program visits, the number of oral therapies, and insulin use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Type 2 diabetes patients with poor glycemic control are found disproportionately in referral specialist care clinics. These functionally refractory patients demonstrate features that may assist in predicting their potential outcome, and may represent a group with specific barriers to care. Specialist patient registries, such as the <jats:styled-content style=\"fixed-case\">LMC D<\/jats:styled-content>iabetes <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>egistry, may provide critical information regarding this cohort.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1753-0407.12257","type":"journal-article","created":{"date-parts":[[2015,1,7]],"date-time":"2015-01-07T09:49:40Z","timestamp":1420624180000},"page":"76-85","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Specialist\u2010led diabetes registries and predictors of poor glycemic control in type 2 diabetes: Insights into the functionally refractory patient from the <scp>LMC D<\/scp>iabetes <scp>R<\/scp>egistry database"],"prefix":"10.1111","volume":"8","author":[{"given":"Ronnie","family":"Aronson","sequence":"first","affiliation":[{"name":"LMC Diabetes &amp; Endocrinology University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Orzech","sequence":"additional","affiliation":[{"name":"LMC Diabetes &amp; 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