Introduction and Objective: Poor glycemic control contributes to microvascular and macrovascular complications, yet real-world effectiveness of multidisciplinary diabetes interventions remains variable. The objective of this project was to determine whether a multidisciplinary, team-based primary care intervention improves hemoglobin A1c (HbA1c) over 18 months among adults with type 2 diabetes and elevated baseline HbA1c levels. Methods: A retrospective quality improvement analysis was conducted among adults receiving primary care within an urban health system. Individuals with a baseline and follow-up HbA1c within an 18-month period were included. The intervention was a team-based primary care model in which patients received structured medication optimization through embedded clinical pharmacy support, with referral-based endocrinology consultation, nutrition counseling, and social work or community health worker services as clinically indicated. The primary outcome was the change in HbA1c from baseline to the most recent measurement. Paired t-tests and effect sizes were used to assess within-person change. Results: Sixty-five adults met inclusion criteria (mean age 61 years; 58% female). Mean baseline HbA1c was 11.3%. Mean follow-up HbA1c was 9.2%, representing a mean reduction of 2.1%. HbA1c improvement was statistically significant (p0.001) with a large effect size (Cohen’s d=0.93). Reductions were observed across all levels of multidisciplinary service intensity. Conclusion: A multidisciplinary, team-based diabetes management approach was associated with significant and clinically meaningful reductions in HbA1c over 18 months in an urban primary care population. These findings support the continued integration of coordinated, specialty-supported care models to improve glycemic outcomes in people with diabetes and warrant further evaluation in prospective studies. Disclosure M. Yabe: None. M.M. Sawh: None. S. Coriolan: None. M. Mikhail: None. J. Che: None. A. Dintakurti: None. N. Hamdan: None. H. Heydari: None. R.J. Silver: Advisory Panel; Current; Novo Nordisk. Consultant; Current; Vertex Pharmaceuticals Incorporated. A.B. Leong: None.
Yabe et al. (Fri,) studied this question.