Clinical and Behavioral Correlates of Achieving and Maintaining Glycemic Targets in an Underserved Population with Type 2 Diabetes
- Valerie Ruelas, MSW*,
- G. Michael Roybal, MD, MPH#,
- Yang Lu, MPhil+,
- Dana Goldman, PhD+ and
- Anne Peters, MD (momofmax{at}mac.com)*
- *USC Keck School of Medicine, Los Angeles, California
- #Los Angeles County Department of Health Services, Los Angeles, CA
- +RAND, Santa Monica, CA
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.
Methods: Randomized, prospective, observational study in which patients enrolled in our program were followed for two years with outcomes measures and questionnaires assessed at baseline, 6, 12 and 24 months.
Results: Overall HbA1c levels fell by 1%. Adherence to medication was the strongest predictor of reaching the target HbA1c of <8%; baseline HbA1c level 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.
Conclusion: Diabetes disease management is effective in a lower income Latino population. However, adherence was suboptimal even when medications are provided on-site for free. Further research into barriers associated with medication adherence is needed.
Footnotes
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- Received July 4, 2008.
- Accepted October 6, 2008.
- Copyright © American Diabetes Association
