Disease management for diabetes mellitus: impact on hemoglobin A1c.

摘要: OBJECTIVE To describe outcomes associated with a health maintenance organization (HMO)-sponsored disease management program for diabetes. STUDY DESIGN Descriptive study that compared of patients diabetes before and after entry into program. PATIENTS AND METHODS The was conducted in mixed-model HMO 275,000 members. included Steering Committee, clinical guidelines, primary care site-based education, coverage glucose meters strips, simplified reporting, support leadership. Data were obtained 5332 continuously enrolled who voluntarily entered the program; 3291 (61.7%) received 3 months or more follow-up, 663 (12.4%) 1 year follow-up. change from baseline mean hemoglobin A1c (HbA1c) medication use RESULTS HbA1c all participants 8.51% (standard deviation [SD] = 1.86%). At value 2794 (84.0%) had decreased to 7.41% (SD 1.33%; P .0001). value, available 605 (91.3%), 8.76% 1.87%) 1.24%; Among insulin increased 30.0% 31.6%, sulfonylurea 40.7% 33.8%. Troglitazone metformin 7.7% 23.8%, respectively, 16.4% 28.8%, respectively. CONCLUSIONS Our data suggest multifaceted can result significant short-term improvements glycemic control managed setting. While improvement accompanied by an increase insulin, troglitazone, metformin, we influence on among our should be considered future studies this area.