Predictors of Achieving Glycemic Targets among People with Type 2 Diabetes—The CARRS Trial

While poor glycemic (A1c), blood pressure (BP), and lipid control are common in patients with diabetes, the CARRS Trial among 1,146 type 2 diabetes patients showed the effectiveness of a multicomponent intervention (care coordinators and decision-support electronic health records). Compared to usual care, the intervention was associated with twice the probability of achieving glycemic and combined diabetes care goals (A1c<7% and BP<130/80 mmHg or LDLc<100 mg/dl). In absolute terms, however, only 20% of the intervention participants achieved glycemic targets. In this analysis, we evaluated the predictors of achieving good (A1c<7%) and avoiding poor glycemic control (A1c>9%) among CARRS participants (mean age: 54.2 years, median diabetes duration: 7 years and mean A1c:9.9%). Using generalized estimating equations, we analyzed four regression models (demographics, disease-related, self-care and other risk factors) to identify predictors of glycemic control, adjusting for intervention. We found income, education, diabetes duration, adherence to prescribed medication/diet/exercise, and diabetic retinopathy to be significantly associated with glycemic control (Table 1). Our data highlight the importance of tailoring treatments based on patients’ socioeconomic status (SES) and disease severity and also further research into innovations to facilitate better self-care in lower SES groups.