Clinical and behavioral correlates of achieving and maintaining glycemic targets in an underserved population with type 2 diabetes

Diabetes Care. 2009 Jan;32(1):54-6. doi: 10.2337/dc08-1234. Epub 2008 Oct 17.

Abstract

Objective: In an underserved Latino area, we established a disease-management program and proved its effectiveness. However, many patients still remained above target. This study was designed to evaluate which factors are associated with reaching program goals.

Research design and methods: This was a randomized, prospective, observational study in which patients enrolled in our program were followed for 2 years with outcomes, measures, and questionnaires assessed at baseline and at 6, 12, and 24 months.

Results: Overall, A1C fell by 1%. Adherence to medication was the strongest predictor of reaching the target A1C of <8%; baseline A1C was also predictive. Knowledge scores increased in those who reached target, but the measures of self-efficacy and empowerment did not change for either group.

Conclusions: Diabetes management is effective in a lower-income Latino population. However, adherence was suboptimal even when medications were provided on-site for free. Further research into barriers associated with medication adherence is needed.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism*
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / rehabilitation
  • Follow-Up Studies
  • Hispanic or Latino*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Los Angeles
  • Medically Underserved Area*
  • Metformin / therapeutic use
  • Odds Ratio
  • Patient Compliance*
  • Poverty*
  • Time Factors

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin
  • Metformin