Background: On average, patients in Japan with type 2 diabetes mellitus have a clinical consultation every month,\nalthough evidence for a favorable follow-up interval is lacking. This study investigated whether the follow-up\ninterval can be extended by comparing the clinical outcomes and cost for monthly versus bimonthly follow-up of\npatients with well-controlled diabetes mellitus.\nMethods: We combined administrative claims data from the National Health Insurance and the Health Checkups\nProgram data of Tsu city, Japan between 2011 and 2014 to conduct a retrospective cohort study of patients with\nwell-controlled type 2 diabetes mellitus. Propensity scores were used to assemble a matched-pairs cohort from\npatients who had monthly and bimonthly follow-up. Equivalence between two groups was assessed by\ndesignating the proportion of patients who maintained good control of their diabetes in the subsequent year as a\nprimary outcome. The proportion achieving target blood pressure and lipid levels, favorable lifestyle, and annual\ncost were compared as secondary outcomes.\nResults: Of 12,145 participants, 693 with monthly follow-up and 693 with bimonthly follow-up were matched using\npropensity scores. In the monthly follow-up group 654 (94.4%) remained under good diabetic control, versus 658\n(95.0%) in the bimonthly group (difference: 0.6%; 95% confidence interval: - 1.8 to 2.9%). All secondary outcomes\nwere equivalent for the monthly and bimonthly follow-up groups except the proportion achieving target blood\npressure, the proportion engaging in regular exercise, and annual cost.\nConclusions: For patients with well-controlled diabetes mellitus, although frequent follow-up by a physician does\nnot affect the control of blood glucose level in the subsequent year, the annual treatment cost becomes much\nhigher. We suggest that patients with well-controlled diabetes can be followed up less often.
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