Participation in the Health Extension for Diabetes program was associated with significant reductions in both clinical (p<0.005) and self-reported (p<0.001) A1c.
Observational (n=383)
Does the Health Extension for Diabetes (HED) program reduce A1c in patients with diabetes?
Participation in a community-based diabetes support program significantly reduced A1c, with self-reported A1c demonstrating strong agreement with clinical values.
p-value: p=<0.005
Introduction and Objective: Treatment of diabetes is expensive and highly burdensome due to frequent comorbid conditions and lifetime management. Participation in a diabetes support program (DSP) can improve diabetes self-management and reduce A1c, thereby delaying or reducing the risk of diabetes-related complications. The objective of this study is to evaluate pre- to post-program changes in A1c and assess agreement between self-reported and clinically measured A1c values among participants of the Health Extension for Diabetes (HED) program, a community-based DSP. Methods: Study participants are patients of a large healthcare system in South Carolina. Clinical A1c values were retrieved through the electronic health record; self-reported data was collected before and after HED participation. Participants provided informed consent and at least one A1c measure (clinical or self-reported, pre- or post-program). Clinical values collected more than six months before or after program participation were excluded. Due to non-normal distributions, matched pairs analyses were used to assess differences between self-reported and clinically measured A1c at the pre- and post-program timepoint. Results: Statistically significant reductions were observed in both clinical (N = 267, Z = 2.795, p 0.005) and self-reported (N = 383, Z = 7.272, p .001) A1c from pre- to post-program. No statistically significant difference was observed between self-reported and clinical A1c at baseline (N = 304, Z = 0.191, p = 0.849) or post-program (N = 109, Z = 0.844, p = 0.399). Conclusion: Participation in HED was associated with significant reductions in both clinical and self-reported A1c. Self-reported A1c demonstrated strong agreement with clinical A1c values, suggesting it may serve as a feasible alternative outcome measure for community-based DSPs that lack access to clinical partnerships or laboratory data. Future research should further validate the use of self-reported A1c across diverse populations and assess potential measurement error. Disclosure A. Diblin: None. S. Kanny: None. A. Pulido: None. J.H. Evatt: None. W.W. sherrill: None. Funding American Diabetes Association (11-22-ICTSN-04)
DIBLIN et al. (2026) conducted an observational in Diabetes (n=383). Health Extension for Diabetes (HED) program vs. Pre-program baseline was evaluated on Change in A1c from pre- to post-program (p=<0.005). Participation in the Health Extension for Diabetes program was associated with significant reductions in both clinical (p<0.005) and self-reported (p<0.001) A1c.