Clinical and Behavioral Correlates of Achieving and Maintaining Glycemic Targets in an Underserved Population With Type 2 Diabetes

  1. Valerie Ruelas, MSW1,
  2. G. Michael Roybal, MD, MPH2,
  3. Yang Lu, MPHIL3,
  4. Dana Goldman, PHD3 and
  5. Anne Peters, MD1
  1. 1University of Southern California Keck School of Medicine, Los Angeles, California
  2. 2Los Angeles County Department of Health Services, Los Angeles, California
  3. 3Research and Development (RAND) Corporation, Santa Monica, California
  1. Corresponding author: Anne Peters, momofmax{at}mac.com

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.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 17 October 2008.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted October 6, 2008.
    • Received July 4, 2008.
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  1. Published online before print October 17, 2008, doi: 10.2337/dc08-1234 Diabetes Care January 2009 vol. 32 no. 1 54-56
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