A1C Outcome Measures to Evaluate the Efficacy of Individual Diabetes Education in a Part Time Diabetes Education Clinic.

Abstract

The Kapuskasing Diabetes Education Centre ( KDEC) is a part time diabetes program (2 days/wk), member of the Northern Diabetes Health Network. KDEC provides diabetes education services for individuals with prediabetes , diabetes, gestational. The objective of the study was to measure the effectiveness of the education provided by the Registered Nurse(RN), Registered Dietitian(RD) in the management of diabetes. The measurement used to evaluate the outcome was the Glycosylated Hemoglobin Level (AlC) at the baseline in comparison with subsequent results. A chart review of the A1C results for the clients seen as new referred, re-referrals ( not seen in the past 2 years) and/or follow up for the time period of July 2006 to July 2007 was performed. The criteria in the selection of the charts was to have the A1C results present. A total 305 charts met the criteria but 41 charts were rejected as there was only one A1C result available. A subdivision of the remaining charts was done. Group A : baseline A1C results above 7 % ; 99 charts met the criteria. Group B : baseline A1C results below 7 % ;165 charts met the criteria. In both groups, a review of the A1C results looking at the improvement or the deterioration of the A1C from baseline to the latest A1C results was performed. For instance , if the A1C was above 7 % , remained above 7 %, but improved , went from 9 % to 8.2 %, it was counted as improved even though it was not yet in the target range below 7 %. Group A: initial A1C above 7%: 72 % of the individual's improved and 27 % deteriorated (was higher then the baseline). Group B: initial A1C below 7 %: 91 % improved or remained below 7 % ; 9 % deteriorated: A1C was above 7%. The overall 84% improved their A1C level and 16 % deteriorated and were above 7 %. Conclusion : The majority of the clientele receiving diabetes education with one on one individual counseling with the RN and the RD in a part time program improved their A1C baseline.