Hemoglobin A1c improvements and better diabetes-specific quality of life among participants completing diabetes self-management programs: A nested cohort study

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• 作者：Abhinav Khanna (1)
  Amber L Bush (1) (2)
  J Michael Swint (3)
  Melissa Fleschler Peskin (4)
  Richard L Street Jr (1) (2) (5)
  Aanand D Naik (1) (2)
  
• 关键词：Diabetes ; specific quality of life ; Diabetes ; Quality of life ; Diabetes ; 39 ; Self ; management ; Hemoglobin A1c
• 刊名：Health and Quality of Life Outcomes
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：10
• 期：1
• 全文大小：200KB
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• 作者单位：Abhinav Khanna (1)
  Amber L Bush (1) (2)
  J Michael Swint (3)
  Melissa Fleschler Peskin (4)
  Richard L Street Jr (1) (2) (5)
  Aanand D Naik (1) (2)
  
  1. Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
  2. Houston Health Services Research and Development, Center of Excellence, Michael E. DeBakey VA Medical Center (152), 2002 Holcombe Blvd, Houston, TX, 77030, USA
  3. University of Texas School of Public Health, 1200 Hermann Pressler, Room E933, Houston, TX, 77030, USA
  4. University of Texas School of Public Health, 7000 Fannin, Suite 2648, Houston, TX, 77030, USA
  5. Department of Communication, Office: 205C Bolton, Texas A&M University, College Station, TX, 77843-4234, USA
  

文摘

Background Numerous primary care innovations emphasize patient-centered processes of care. Within the context of these innovations, greater understanding is needed of the relationship between improvements in clinical endpoints and patient-centered outcomes. To address this gap, we evaluated the association between glycosylated hemoglobin (HbA1c) and diabetes-specific quality of life among patients completing diabetes self-management programs. Methods We conducted a retrospective cohort study nested within a randomized comparative effectiveness trial of diabetes self-management interventions in 75 diabetic patients. Multiple linear regression models were developed to examine the relationship between change in HbA1c from baseline to one-year follow-up and Diabetes-39 (a diabetes-specific quality of life measure) at one year. Results HbA1c levels improved for the overall cohort from baseline to one-year follow-up (t (74)--.09, p--0029). One-year follow up HbA1c was correlated with worse overall quality of life (r--.33, p--.004). Improvements in HbA1c from baseline to one-year follow-up were associated with greater D-39 diabetes control (β = 0.23, p--04) and D-39 sexual functioning (β = 0.25, p--03) quality of life subscales. Conclusions Improvements in HbA1c among participants completing a diabetes self-management program were associated with better diabetes-specific quality of life. Innovations in primary care that engage patients in self-management and improve clinical biomarkers, such as HbA1c, may also be associated with better quality of life, a key outcome from the patient perspective.