Impact of patient level factors on the improvement of the ABCs of diabetes

Abstract

Objective To determine which patient factors contribute to improvements in the ABCs of diabetes following a multi-faceted diabetes care intervention. Methods A multi-level, cluster design, randomized controlled trial examined the effectiveness of a Chronic Care Model (CCM) intervention in an underserved community ( n = 119). Results Improvements in glycemic control were experienced among older subjects ( p = 0.02), those with higher scores on the WHO-10 Quality of Well-Being Subscale 1 ( p = 0.05), and those in the CCM group ( p = 0.04). Insulin use was associated with greater improvements in SBP and DBP. Those taking insulin ( p = 0.07), and those more satisfied with their diabetes care and ready to make a behavior change ( p = 0.08) experienced larger improvements in Non-HDLc. Medication treatment intensification (TI) did not significantly impact the ABCs. Conclusion Psychosocial and sociodemographic factors explained more of the variation in the ABCs than TI, and are important contributors to clinical improvement. Practice Implications Providers may be able to identify and intervene on patients who are at risk for developing diabetes complications and improve the consistency, quality, and effectiveness of patient care.