An Outpatient Model of Integrated Diabetes Treatment and Education: Functional, Metabolic, and Knowledge Outcomes

Abstract

A cohort of 137 insulin-treated adults with diabetes was evaluated at enrollment in a diabetes education and care program; 69 completed follow-up evaluations (mean = 11.2 months) to ascertain clinical outcomes. Factors that predicted change in metabolic, functional, and knowledge status were identified. The metabolic status of this cohort also was compared with a similar group of patients from a health maintenance organization (HMO) in a neighboring state. The mean HbA1c decreased from 9.97% at enrollment to 7.53% at follow-up. Functional status scores did not improve from baseline to follow-up. The relationship between knowledge and metabolic control differed for subjects with diabetes of long duration and short duration. A predictor of improved HbA1c was baseline HbA1c. A predictor of improved symptom score included white race or Hispanic origin. Patients who attended this program had better metabolic outcomes than the comparison group of patients.