Efficacy of a staged diabetes management programme in achieving glycaemic goal in a low socio‐economic Hispanic population

The aim of this study was to identify the efficacy of a staged diabetes management (SDM) clinic serving a low socio‐economic Hispanic population in achieving glycaemic goal. We analysed prospectively collected data from patients discharged from the clinic in 2008 with an admission HbA1c >8% (64mmol/mol) and >one clinic visit. Adjusted odds ratios (AOR) were determined for factors significantly associated with glycaemic goal achievement. Both those patients who achieved the clinic HbA1c goal of ≤8% (n=277) and those who did not (n=209) had a clinically significant decrease in HbA1c (‐3.13±1.80, ‐1.08±1.78). After adjustment, the following were associated with failure to achieve goal: higher admission HbA1c (%) 11.0±1.8 vs 10.3±1.7, AOR (95% CI) 1.22 (1.08, 1.37), p=0.0016; higher admission insulin (IU/kg/day) 0.56±0.58 vs 0.26±0.41, AOR 2.08 (1.09, 4.00), p=0.026; greater increase in insulin (IU/kg/day) 0.23±0.46 vs 0.09±0.32, AOR 2.38 (1.15, 5.00), p=0.02; and a longer stay (days) 229±110 vs 172±84, AOR 1.007 (1.003, 1.012), p=0.0008. In this SDM clinic, most patients achieved significant reduction in HbA1c. The study identified factors associated with a lower likelihood of achieving goal thereby demonstrating the value of review of the response to an SDM protocol in indicating areas for further improvement.