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Diabetes control improved when inner-city patients received graphic feedback about glycosylated hemoglobin levels
Rebecca B Chapin1, Derrick C Williams, Richard F Adair
1Department of Medical Education, Abbott Northwestern Hospital, Minneapolis, Minn 55407-3799, USA.
Objective:
To develop and test an inexpensive visual tool to help patients with diabetes improve glycemic control.
Methods:
A multidisciplinary team developed a 1-page form, the "Take-home Diabetes Record" (THDR), providing feedback to patients by displaying per cent glycosylated hemoglobin (GHb) values graphically over time, with target levels highlighted. Patients with type 2 diabetes in an inner-city clinic were randomized to THDR use (n = 57) or not (n = 70) over 15 months. Self-care activities were discussed, linked with GHb results, and charted at each clinic visit. Initial and final GHb were compared.
Results:
Mean GHb fell significantly in THDR patients (-0.94, P =.003), but not in control patients (-0.18, P =.36). Mean GHb decrease was greater in THDR patients (P =.047). A greater proportion of THDR patients (51%) than control patients (18%) achieved a decrease in GHb >/=0.9 (P =.001).
Conclusions:
A graph linking GHb and self-care activities shows promise for improving glycemic control.