The Importance of Clinical Pharmacists in Improving Blood Glucose and Lipid Levels in Patients with Diabetes and Myocardial Infarction

• Published in: Diabetes, metabolic syndrome and obesity Vol. 16; pp. 2733 - 2744
• Main Authors: Shi, Fang-Hong, Yu, Bin-Bin, Shen, Long, Xu, Li, Jiang, Yi-Hong, Gu, Zhi-Chun, Lin, Hou-Wen, Li, Hao
• Format: Journal Article
• Language: English
• Published: Dove Medical Press Limited 30.09.2023; Dove; Dove Medical Press
• Subjects: blood glucose; blood lipid; Blood sugar; clinical pharmacist's intervention; complex diabetes; Diabetics; Glycosylated hemoglobin; Heart attack; Low density lipoproteins; Medical colleges; Original Research; Patient compliance; Pharmacists; propensity score matching; China
• ISSN: 1178-7007; 1178-7007
• DOI: 10.2147/DMSO.S425960

Purpose: The aim of this study was to evaluate whether intervention by clinical pharmacists can improve blood glucose and lipid levels in diabetic patients with complex medical conditions. Methods: The retrospective database included 138 patients with diabetes who had presented with acute myocardial infarction (AMI) between January 2019 and October 2021. Blood glucose and lipid levels were measured within 12 weeks and 78 weeks of follow-up. Propensity score matching (PSM) was used to balance the confounding effects of patients' characteristics. Results: A total of 138 eligible patients were assigned to either the intervention group (n = 47) or the usual care group (n = 91). After the intervention, there were significant improvements in blood glucose (glycosylated hemoglobin-HbA1C % from 9.0 to 8.3; fasting blood glucose-FBG mmol/L from 11.3 to 7.1; postprandial blood glucose-PBG mmol/L from 17.0 to 12.1; p < 0.001) and lipid levels (total cholesterol-TC from 4.9 to 3.5, low-density lipoprotein cholesterol-LDL-C from 3.0 to 1.8, p < 0.001, mmol/L) in both followup periods. The blood glucose effects were most pronounced in the PBG control rate (76.9% vs 54.0%) before PSM, while HbA1C% and PBG control rate after PSM were significantly higher in the intervention group (HbA1C% rate: 65.6% vs 38.5%; PBG rate: 79.2% vs 45.8%; p < 0.05, intervention vs non-intervention). Subgroup analysis further confirmed the improvement of blood glucose and lipid mainly in patients with higher baseline FBG ([??]10mmol/L) and moderate follow-up duration (4-12 weeks). Conclusion: The intervention of clinical pharmacists in multidisciplinary team can significantly improve blood glucose and lipid levels in complex type 2 diabetic patients, especially those with high baseline FBG and moderate follow-up durations. Keywords: blood glucose, blood lipid, clinical pharmacist's intervention, propensity score matching, complex diabetes