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Diabetes mellitus is a prevalent, costly condition associated with substantial morbidity and mortality. It is an important public health problem as it is equally burdensome to individuals and to society, and disproportionately affects disadvantaged people and nations. Despite the number of possibilities for reducing much of this burden, the incidence of diabetes continues to grow. New approaches to how diabetes care is delivered are needed to improve care at the patient, provider, community, and health systems levels. It was therefore our objective to explore the effectiveness of implementing a multifaceted diabetes care intervention, based on the Chronic Care Model, into an underserved community, with the goal of changing the way diabetes care is delivered to improve outcomes in patients who receive their diabetes care in the primary care setting. A marked decline in HbA1c was observed in the multifaceted intervention group (-0.6%, p=0.008) but not in the other groups. The magnitude of the association remained strong after adjustment for clustering (p=0.01). The same pattern was observed for a decline in Non-HDL-c and for the proportion of participants who self-monitor blood glucose (SMBG) in the multifaceted intervention group (Non-HDL-c: -10.4 mg/dl, p=0.24; SMBG: +22.2%, p |
