Translating What Works: A New Approach to Improve Diabetes Management

Journal of Diabetes Science and Technology
Lawrence S PhillipsQi Long

Abstract

The most efficacious strategies to improve diabetes control include case management, health care team changes, patient education, and facilitated transmission of patient data to clinicians ("facilitated relay"), but these strategies have not been translated to permit general use in clinical practice. A web-based decision support program was developed to include these features, and assessed in patients who had A1c ≥7.0% despite using metformin with/without sulfonylureas or insulin. Staff entered patients' glucose data, obtained management recommendations, reviewed the plan with a clinician, and discussed the new plan with patients. 113 subjects were 96% male and 32% black, with average age 65.6 years and BMI 32.8. During prior primary care, A1c averaged 8.32 ± 0.16% (SEM). In all patients, baseline A1c was 8.18 ± 0.11%, and decreased to 7.54 ± 0.12%, 7.16 ± 0.13%, and 7.54 ± 0.16% at 3, 6, and 12 months, respectively, all P < .001. In 42 subjects who provided glucose data and made requested changes in medications, A1c was 8.12 ± 0.09% at baseline and fell to 7.29 ± 0.11%, 6.98 ± 0.10%, and 7.05 ± 0.10% at 3, 6, and 12 months, respectively, all P < .001. Chart review of 16 subjects followed for 12 months demonstrated that hypogly...Continue Reading

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Citations

Jan 25, 2017·The Diabetes Educator·Margaret A PowersEva Vivian
Oct 31, 2018·Advances in Therapy·Jennifer OkemahManuel Quiñones
Nov 17, 2016·Wiener klinische Wochenschrift·Jana MakucTajda Keber
Nov 9, 2020·Canadian Journal of Diabetes·Paulina K WrzalNoah M Ivers
May 13, 2021·Semergen·José Javier Mediavilla Bravo

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Methods Mentioned

BETA
pharmacotherapy

Software Mentioned

SAS®

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