Background: Asian American Medical Group serves predominately monolingual senior or low income Chinese immigrants in the San Francisco Bay Area. This clinical study evaluated the difference of A1c improvement between T2DM patients who received DSME along with standard care vs. standard care alone. DSME has been widely underutilized by physicians in the independent practice setting.
Method: In this study, treatment was applied to 36 patients from a sample of 130 with T2DM with A1c >=8% and the average age were 70 years old for both cohorts per electronic medical record from 2017-2018. Before treatment, the treatment group’s average A1c was 9.83% vs. the control group was 8.96%. A dietitian with CDE was assigned to provide 1:1 counseling to patients/patient’s caregiver(s) on diabetes management, implement patient goals, and provide individualized care. RD actively communicated with PCPs for changes in care as needed. This program was provided to patients based on their demands and needs; ranging from 1-5 visits within a year.
Results: A total of 84% of patients receiving DSME reduced their A1c levels; 68% reducing A1c by >= 0.88%, 41% reducing A1c by >=1.76%. Comparatively, 48% of patients who didn’t receive DSME reduced their A1c levels, 37% reducing A1c by >= 0.88% and 25% reducing A1c by >=1.76%. A comparison between the cohorts that experienced an A1c reduction of >=0.88% revealed statistical significance at 95% confidence level (p = 0.0474). The data shows that there is a 31% difference between these two cohorts. Overall, patients receiving treatment experienced a mean reduction in A1c of 1.54% compared to an increase of 0.08% for the control group. Furthermore, 50% from the treatment side did lower A1c <8% whereas only 26% from the control.
Conclusion: The study demonstrated that DSME program improves A1c and points to the value of DSME. Thus, DSME should be promoted and widely utilized as a standard care regiment in the out-patient setting.
E. Situ: None. J. Woo: None. X. Zhang: None.
