TY  - BOOK
AU  - Ahmed, Saba
AU  - Magee, Michelle
AU  - Nassar, Carine M
TI  - Pilot feasibility and efficacy of a strategy to sustain A1C improvement among diverse adults with type 2 diabetes completing a diabetes care management program
SN  - 2052-4897
PY  - 2024///
KW  - *Diabetes Mellitus, Type 2
KW  - Adult
KW  - Aged
KW  - Blood Glucose/an [Analysis]
KW  - Diabetes Mellitus, Type 2/dt [Drug Therapy]
KW  - Feasibility Studies
KW  - Female
KW  - Glycated Hemoglobin
KW  - Humans
KW  - Male
KW  - Medicare
KW  - Middle Aged
KW  - United States
KW  - Automated
KW  - MedStar Diabetes Institute
KW  - MedStar Health Research Institute
KW  - MedStar Washington Hospital Center
KW  - Endocrinology Fellowship
KW  - MedStar Georgetown University Hospital/MedStar Washington Hospital Center
KW  - Journal Article
N2  - CONCLUSIONS: Among completers of a 3-month DCM program, a low intensity 9-month sustaining strategy maintained A1C under 8.0% (HEDIS (Healthcare Effectiveness Data and Information Set) threshold for diabetes control) compared with controls for 15 months after completion of the initial DCM intervention. Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ; INTRODUCTION: Evidence-based strategies are needed to sustain improvements in outcomes following diabetes care management (DCM) programs. We examined the impact of Boot Camp-Plus (BC-Plus), an innovative sustaining strategy, on A1C among adults with type 2 diabetes completing a 3-month Diabetes Boot Camp (DBC). This health system sponsored program consisted of diabetes self-management education and support, medical nutrition therapy and antihyperglycemic medications management; RESEARCH DESIGN AND METHODS: From March 2019 to July 2021, adult DBC completers with Medicare or a health system Medicaid or employee commercial plan were enrolled in BC-Plus for 9 months. DBC completers not meeting insurance eligibility or who declined to participate in BC-Plus acted as controls. During the first 3 months, BC-Plus participants received ongoing daily remote blood glucose (BG) monitoring; and during all 9 months, they received monthly check-in calls with BG review by a medical assistant who addressed needs for supplies/drugs, whether participants were checking BGs, and self-care encouragement. Escalation to a nurse practitioner occurred if the monthly BG trend was >200 mg/dL and/or several BG <80 mg/dL and/or new A1C >9.0% were identified. A1C was followed for an additional 9 months post-BC-Plus. A longitudinal mixed effects analysis was used to assess change in A1C from month 0 to month 21 of follow-up between BC-Plus participants versus controls; RESULTS: A total of 838 DCM completers were identified, among whom 281 joined the BC-Plus intervention and 557 acted as controls. Mean age was 55.9 years; 58.2% were women; 66.2% were black; and 30.6% insured by Medicare. BC-Plus participants experienced significantly lower A1C compared with controls and remained below 8.0% to month 18
UR  - https://dx.doi.org/10.1136/bmjdrc-2023-003788
ER  -