The Impact of Integrated Behavioral Healthcare on Glycemic Control

J Clin Psychol Med Settings. 2022 Sep;29(3):636-644. doi: 10.1007/s10880-021-09817-w. Epub 2021 Aug 26.

Abstract

Integrated behavioral healthcare (IBH) is the "standard of care" to address psychosocial factors impacting diabetes outcomes; it is not standard in practice. This longitudinal, retrospective, chart-review examines IBH impact on glycemic control in an adult diabetes clinic. Adults (n = 374) with ≥ 1 behavioral health encounter, ≥ 2 hemoglobin A1c (HbA1c) values, and HbA1c value > 8% at initial IBH visit were included. Mixed effects linear piecewise models examined differences in slope trajectories for 365 days pre- and post-IBH intervention. Pre-intervention slope was not significant (z = - 1.09, p = 0.28). The post-intervention slope was significant (z = - 6.44, p < 0.001), indicating a significant linear decrease in HbA1c values. Results demonstrated that prior to engaging with behavioral health, there was no change in HbA1c. After initial IBH visit, there was a predicted reduction of > 1% in HbA1c over the following year. These results suggest that IBH significantly improves patients' metabolic status. Next steps for IBH research are offered.

Keywords: Gender differences; Glycemic control; Integrated behavioral health; Type 1 diabetes; Type 2 diabetes.

MeSH terms

  • Adult
  • Delivery of Health Care
  • Diabetes Mellitus, Type 2*
  • Glycated Hemoglobin / analysis
  • Glycemic Control*
  • Humans
  • Retrospective Studies

Substances

  • Glycated Hemoglobin A