More new diabetes patients are being diagnosed in states that have expanded their Medicaid programs under the Affordable Care Act, compared with states that chose not to expand, according to a study published online March 23 in Diabetes Care.

Dr. Harvey Kaufman, senior medical director at Quest Diagnostics, and his colleagues analyzed data from Quest Diagnostics’ corporate database of clinical laboratory services for the first 6 months of 2013 and the same period in 2014, identifying 215,398 with a new diagnosis of diabetes in 2013 and 218,890 in 2014. A total of 26,237 were enrolled in Medicaid in 2013 vs. 29,673 in 2014 – a 13% increase in overall new diagnoses of diabetes.

The increase was greater – 23% – in the 26 states and the District of Columbia that had expanded their Medicaid programs. In states that had not expanded, the increase in newly diagnosed patients was 0.4% (Diabetes Care 2015 March 23 [doi: 10.2337/dc14-2334]).

“It is likely that changes in access to health care for patients with Medicaid contributed to testing for diabetes at an earlier stage of disease,” Dr. Kaufman wrote .

Access to health care also identified patients at earlier stages of diabetes, as evidenced by diagnosis at a lower mean hemoglobin A1c level. In states with expanded Medicaid programs, mean HbA1c was 7.96 at diagnosis, compared to 8.14 in states without expanded Medicaid programs.

“These Medicaid patients with newly identified diabetes will experience better management of their diabetes than if diagnosis had been made later,” Dr.Kaufman wrote. “This could be anticipated to lead to fewer long-term complications.”


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