HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Levetan, C. S. Articles by Ratner, R. E. Search for Related Content PubMed PubMed Citation Articles by Levetan, C. S. Articles by Ratner, R. E. Social Bookmarking                What's this?

Impact of Computer-Generated Personalized Goals on HbA_1c

¹ Department of Internal Medicine, Division of Endocrinology, Washington Hospital Center, Washington, DC
² MedStar Research Institute, Washington, DC.

OBJECTIVE—The public is increasingly aware of the importance of HbA_1c testing, yet the vast majority of patients with diabetes do not know their HbA_1c status or goal. We set forth to evaluate the impact of a system that provides uniquely formatted and personalized reports of diabetes status and goals on changes in HbA_1c levels.

RESEARCH DESIGN AND METHODS—A total of 150 patients with diabetes were randomized to receive either standard care or intervention inclusive of a computer-generated 11" x 17" color poster depicting an individual’s HbA_1c status and goals along with personalized steps to aid in goal achievement. All patients enrolled received diabetes education during the 3 months before enrollment. HbA_1c was performed at baseline and 6 months.

RESULTS—At baseline, there were no significant differences between patient groups in terms of age, sex, education level, race, and HbA_1c or lipid levels. Among patients with baseline HbA_1c 7.0%, there was an 8.6% (0.77% absolute) reduction in HbA_1c among control subjects compared with a 17.0% (1.69% absolute) decline in the intervention group (P = 0.032). There were no differences between the control and intervention groups with respect to the frequency of patients experiencing any decline in HbA_1c (63 vs. 69%, P = 0.87); among these patients experiencing a decline, the most substantial reductions were seen with the control group, which had a 13.3% (1.15% absolute) decline compared with the intervention patients, who reduced their HbA_1c by 24.2% (2.26% absolute reduction; P = 0.0048). At study close, 77% of the patients had their poster displayed on their refrigerator.

CONCLUSIONS—This unique and personalized computer-generated intervention resulted in HbA_1c lowering comparable to that of hypoglycemic agents.

Abbreviations: ADA, American Diabetes Association • CDE, certified diabetes educator

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. Heisler, I. Cole, D. Weir, E. A. Kerr, and R. A. Hayward Does Physician Communication Influence Older Patients' Diabetes Self-Management and Glycemic Control? Results From the Health and Retirement Study (HRS) J. Gerontol. A Biol. Sci. Med. Sci., December 1, 2007; 62(12): 1435 - 1442. [Abstract] [Full Text] [PDF]

				P. Berikai, P. M. Meyer, R. Kazlauskaite, B. Savoy, K. Kozik, and L. Fogelfeld Gain in Patients' Knowledge of Diabetes Management Targets Is Associated With Better Glycemic Control Diabetes Care, June 1, 2007; 30(6): 1587 - 1589. [Full Text] [PDF]

				J.-H. Cho, S.-A. Chang, H.-S. Kwon, Y.-H. Choi, S.-H. Ko, S.-D. Moon, S.-J. Yoo, K.-H. Song, H.-S. Son, H.-S. Kim, et al. Long-Term Effect of the Internet-Based Glucose Monitoring System on HbA1c Reduction and Glucose Stability: A 30-month follow-up study for diabetes management with a ubiquitous medical care system Diabetes Care, December 1, 2006; 29(12): 2625 - 2631. [Abstract] [Full Text] [PDF]

				K. G. Shojania, S. R. Ranji, K. M. McDonald, J. M. Grimshaw, V. Sundaram, R. J. Rushakoff, and D. K. Owens Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA, July 26, 2006; 296(4): 427 - 440. [Abstract] [Full Text] [PDF]

				A. Balasubramanyam, D. Hinnen, and W. Polonsky Cardiovascular Event Prevention in the Person With Type 2 Diabetes: Case Examples for Identifying and Treating Multiple Risks The Diabetes Educator, July 1, 2006; 32(Supplement_5): 163S - 173S. [Full Text] [PDF]

				J. Nobel Bridging the knowledge--action gap in diabetes: information technologies, physician incentives and consumer incentives converge Chronic Illness, March 1, 2006; 2(1): 59 - 69. [Abstract] [PDF]

				A. M. Delamater Clinical Use of Hemoglobin A1c to Improve Diabetes Management Clin. Diabetes, January 1, 2006; 24(1): 6 - 8. [Full Text] [PDF]

				J. Chodosh, S. C. Morton, W. Mojica, M. Maglione, M. J. Suttorp, L. Hilton, S. Rhodes, and P. Shekelle Meta-Analysis: Chronic Disease Self-Management Programs for Older Adults Ann Intern Med, September 20, 2005; 143(6): 427 - 438. [Abstract] [Full Text] [PDF]

				M. Heisler, J. D. Piette, M. Spencer, E. Kieffer, and S. Vijan The Relationship Between Knowledge of Recent HbA1c Values and Diabetes Care Understanding and Self-Management Diabetes Care, April 1, 2005; 28(4): 816 - 822. [Abstract] [Full Text] [PDF]

				H.-S. Kwon, J.-H. Cho, H.-S. Kim, B.-R. Song, S.-H. Ko, J.-M. Lee, S.-R. Kim, S.-A. Chang, H.-S. Kim, B.-Y. Cha, et al. Establishment of Blood Glucose Monitoring System Using the Internet Diabetes Care, February 1, 2004; 27(2): 478 - 483. [Abstract] [Full Text] [PDF]