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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Health and Quality of Life Outcomes 1/2012

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

Zeitschrift:
Health and Quality of Life Outcomes > Ausgabe 1/2012
Autoren:
Abhinav Khanna, Amber L Bush, J Michael Swint, Melissa Fleschler Peskin, Richard L Street Jr, Aanand D Naik
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

AK and AN conceived of the study and participated in its design. AK drafted the manuscript. AB conducted statistical analysis and helped draft the manuscript. AN participated in study conception and design, helped draft the manuscript, and conducted the parent study from which data for this study was derived. JS, RS, and MP contributed to interpretation of data, revising manuscript critically, and final approval of the version submitted to the journal. All authors read and approved the final manuscript

Abstract

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) = 3.09, p = .0029). One-year follow up HbA1c was correlated with worse overall quality of life (r = 0.33, p = 0.004). 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.
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