Gain in Patients' Knowledge of Diabetes Management Targets Is Associated With Better Glycemic Control

Berikai, Padmalatha; Meyer, Peter; Kazlauskaite, Rasa; Savoy, Barbara; Kozik, Kelly; Fogelfeld, Leon

doi:10.2337/dc06-2026

Cited by 69 publications

(55 citation statements)

References 20 publications

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“…The delivery of similar DSME interventions have produced mixed improvement to A1C after 6 months (Berikai et al, 2007;Tang, Funnell, Noorulla, Oh, & Brown, 2012;Utz et al, 2008). Understanding the differential effects seen between the various It is also possible that the intervention delivered at HHDC was more effective than those implemented at the three remaining sites.…”

Section: Researchmentioning

confidence: 99%

Measuring the Implementation and Effects of a Coordinated Care Model Featuring Diabetes Self-management Education Within Four Patient-Centered Medical Homes

et al. 2015

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Minority individuals experience a disproportionately greater incidence and prevalence of type 2 diabetes. Innovative approaches are needed to reduce health disparities and associated harms among vulnerable populations with diabetes. This thesis examines the effects of the implementation of a coordinated care model with underserved populations in Patient Centered Medical Homes (PCMH) at four sites (Florida, Ohio, Oklahoma, and Tennessee). The model featured diabetes self-management education (DSME) and a patient support intervention delivered within the PCMH context. The components of the comprehensive intervention included DSME, support for managing diabetes and distress, enhanced access and linkage to care, and improvement to quality of care. The primary dependent measures in this study included four clinical health measures-glycosylated hemoglobin (A1C), blood pressure, body mass index, and lipids-and the AADE7 Self-Care Behaviors TM . Coordinated care teams that delivered the intervention included primary care physicians, nurse care coordinators, certified diabetes educators, health behavior coaches, and diabetes patient supporters. Community health workers and medical assistants provided additional individualized support to patients. Care teams provided DSME as well as customized and coordinated patient support within a PCMH setting.This study was part of a larger participatory evaluation of the Bristol-Myers Squibb Foundation's Together on Diabetes initiative. A statistically significant decrease was seen in A1C, the primary clinical health outcome. This decrease was seen across all four implementation sites; ranging from a decrease of 0.4% to 0.9% after 6 months. This improved A1C level was associated with implementation of the DSME and support intervention. Substantial policy and practice changes were also brought about at two of the four PCMH sites. Use of DSME within the PCMH model is a promising strategy for reducing clinical markers for diabetes among vulnerable populations.iv Systems changes, including policy and practice changes, have the potential to have lasting effects within PCMH practice for reducing the burden of diabetes.

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Section: Researchmentioning

confidence: 99%

Measuring the Implementation and Effects of a Coordinated Care Model Featuring Diabetes Self-management Education Within Four Patient-Centered Medical Homes

et al. 2015

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“…High-quality diabetes self-management education (DSME) has been shown to improve patient self-management, satisfaction, and glucose control (25,26), as has delivery of ongoing diabetes self-management support (DSMS), so that gains achieved during DSME are sustained (27)(28)(29). National DSME standards call for an integrated approach that includes clinical content and skills, behavioral strategies (goal setting, problem solving), and engagement with emotional concerns in each needed curriculum content area.…”

Section: Objective 2: Support Patient Behavior Changementioning

confidence: 99%

1. Strategies for Improving Care

2014

Diabetes Care

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“…6 Among patients with diabetes, lower HbA1c levels have been associated with decreased mortality [7][8][9] and fewer complications. [10][11][12][13][14] Research suggests that performance of self-care behaviors, [15][16][17][18][19][20][21] increased diabetes knowledge, [22][23][24] and greater medication adherence [25][26][27][28] are associated with improved glycemic control.…”

mentioning

confidence: 99%

Associations Between Health Literacy, Diabetes Knowledge, Self-Care Behaviors, and Glycemic Control in a Low Income Population with Type 2 Diabetes

Bains

Egede

2011

Diabetes Technology & Therapeutics

233

225

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Objective: This study assessed associations among health literacy, diabetes knowledge, self-care, and glycemic control in a low income, predominately minority population with type 2 diabetes. Methods: One hundred twenty-five adults with diabetes were recruited from a primary care clinic. Subjects completed validated surveys to measure health literacy, diabetes knowledge, and self-care (medication adherence, diet, exercise, blood sugar testing, and foot care). Hemoglobin A1c values were extracted from the medical record. Spearman's correlation and multiple linear regression were used to assess the relationship among health literacy, diabetes knowledge, self-care, and glycemic control controlling for covariates. Results: Cronbach's a was 0.95 for the Revised Rapid Estimate of Adult Literacy in Medicine. The majority of the sample was <65 years old (50.7%), female (72.5%), and African American (71.4%), had less than a high school education (68.2%) and a household income <$15,000 (64.2%), and reported their health status as worse than last year (73.9%). In adjusted models that examined the associations among health literacy, diabetes knowledge, medication adherence, and self-care, health literacy was only significantly associated with diabetes knowledge (b ¼ 0.55; 95% confidence interval [CI] 0.29, 0.82). In the final adjusted model for independent factors associated with glycemic control, both diabetes knowledge (b ¼ 0.12; 95% CI 0.01, 0.23) and perceived health status (b ¼ 1.14; 95% CI 0.13, 2.16) were significantly associated with glycemic control, whereas health literacy was not associated with glycemic control (b ¼ À0.03; 95% CI À0.19, 0.13). Conclusions: Diabetes knowledge and perceived health status are the most important factors associated with glycemic control in this population. Health literacy appears to exert its influence through diabetes knowledge and is not directly related to self-care or medication adherence.

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Gain in Patients' Knowledge of Diabetes Management Targets Is Associated With Better Glycemic Control

Cited by 69 publications

References 20 publications

Measuring the Implementation and Effects of a Coordinated Care Model Featuring Diabetes Self-management Education Within Four Patient-Centered Medical Homes

Measuring the Implementation and Effects of a Coordinated Care Model Featuring Diabetes Self-management Education Within Four Patient-Centered Medical Homes

1. Strategies for Improving Care

Associations Between Health Literacy, Diabetes Knowledge, Self-Care Behaviors, and Glycemic Control in a Low Income Population with Type 2 Diabetes

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