Hemoglobin A1c improvements and better diabetes-specific quality of life among participants completing diabetes self-management programs: A nested cohort study
Open accessAbstract
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 (HbA 1c) 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 HbA 1c from baseline to one-year follow-up and Diabetes-39 (a diabetes-specific quality of life measure) at one year. Results: HbA 1c levels improved for the overall cohort from baseline to one-year follow-up (t (74) = 3.09, p = .0029). One-year follow up HbA 1c was correlated with worse overall quality of life (r = 0.33, p = 0.004). Improvements in HbA 1c 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 HbA 1c 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 HbA 1c, may also be associated with better quality of life, a key outcome from the patient perspective.
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In many clinical conditions, such as diabetes mellitus and congestive heart failure, outcomes and quality of life are improved when patients have access to their clinical data and play a role in managing their own symptoms.
“In many clinical conditions, such as diabetes mellitus and congestive heart failure, 63 outcomes and QOL are improved when patients have access to their clinical data and play a role in managing their own symptoms.64,65”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [65]
The Methods (Diabetes self-management programs; page unavailable) say participants reviewed their individual HbA1c, blood-pressure, and cholesterol levels and received self-management education. The Conclusion (page unavailable) associates improved HbA1c with better diabetes-specific quality of life. The paper does not establish that access to clinical data or self-management caused those improvements, and it does not study congestive heart failure. (LLM, conf=0.88)
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- Authors
- Khanna, A., Bush, A. L., Swint, J. M., Peskin, M. F., Street, R. L., & Naik, A. D.
- Affiliations
- Baylor College of Medicine (US)
- The University of Texas Health Science Center at Houston (US)
- Michael E. DeBakey VA Medical Center (US)
- Corresponding author
- Naik, Aanand D
- Venue
- Health and Quality of Life Outcomes
- Published
- 2012-05-14
- Volume
- 10
- Issue
- 1
- Pages
- 48-48
- ISSN
- 1477-7525 (ISSN-L)
- PMC
- PMC3412738
- OpenAlex
- W2129449249
- Cited by
- 50
- References
- 46
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 6 · 2015: 6 · 2014: 5 · 2013: 5 · 2012: 1
- FWCI
- 4.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Health and Quality of Life Outcomes (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Commons-TMC (Texas Medical Center) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- OakTrust (Texas A&M University Libraries) (submittedVersion)
- Funders
- Doris Duke Charitable Foundation
- Health Services Research and Development
- Agency for Healthcare Research and Quality (U18HS016093)
- National Institute on Aging (K23AG027144)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- diabetes self-management program, HbA1c, diabetes-specific quality of life, glycemic control, sexual function, patient-centered outcomes, primary care innovation, patient engagement
- MeSH terms
- Aged, Aged, 80 and over, Deductibles and Coinsurance, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Glycated Hemoglobin, Hospitals, Veterans, Humans, Hypoglycemic Agents, Male, Middle Aged, Outcome and Process Assessment, Health Care, Pilot Projects, Quality of Life, Surveys and Questionnaires, Retrospective Studies, Self Care, Socioeconomic Factors, Texas, Veterans, Blood Glucose Self-Monitoring, Cohort Studies, Body Mass Index, Linear Models, Cost of Illness, Comparative Effectiveness Research
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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