Longitudinal study of a diabetes education and care intervention: Predictors of improved glycemic control

Abstract: Background: This study prospectively identifies those characteristics of office patients with diabetes that predict subsequent improvement in glycemic control in response to an educational intervention. Metbods: Data on demographic factors, disease characteristics, and glycemic control were obtained on a consecutive series of patients referred by their primary physician to a 4-day outpatient diabetes education and care program. Follow-up measurement of g1ycosyIated hemoglobin (HbAtc) was obtained from the same laboratory 2 months later. Analysis using logistic response models identified baseline characteristics associated with improved HbAtc. Results: Among the 169 study subjects, 74 (44 percent) had at least a 20 percent improvement in HbAtc levels 2 months after the program. Among these subjects, mean HbAtc level was 10.6 percent before and 7.4 percent 2 months after the program. Factors associated with improvement in HbAtc values in bivariate and multivariate logistic models included duration of diabetes less than 2 years (risk ratio = 1.90, 95 percent confidence interval (CI) 1.30-2.76) and initial HbAtc level greater than 10 percent (risk ratio = 2.75,95 percent CI 2.08-4.01). Baseline functional status, health locus of control, social support, knowledge of diabetes self-care, age, weight as percentage of ideal body weight, age at diagnosis, race, sex, family history of diabetes, type of diabetes, and mode of treatment were not significant predictors of improved HbAtc