Impact of Computer-Generated Personalized Goals on HbA1c

Abstract

OBJECTIVE—The public is increasingly aware of the importance of HbA1c testing, yet the vast majority of patients with diabetes do not know their HbA1c status or goal. We set forth to evaluate the impact of a system that provides uniquely formatted and personalized reports of diabetes status and goals on changes in HbA1c levels. RESEARCH DESIGN AND METHODS—A total of 150 patients with diabetes were randomized to receive either standard care or intervention inclusive of a computer-generated 11” × 17” color poster depicting an individual’s HbA1c status and goals along with personalized steps to aid in goal achievement. All patients enrolled received diabetes education during the 3 months before enrollment. HbA1c was performed at baseline and 6 months. RESULTS—At baseline, there were no significant differences between patient groups in terms of age, sex, education level, race, and HbA1c or lipid levels. Among patients with baseline HbA1c ≥7.0%, there was an 8.6% (0.77% absolute) reduction in HbA1c among control subjects compared with a 17.0% (1.69% absolute) decline in the intervention group (P = 0.032). There were no differences between the control and intervention groups with respect to the frequency of patients experiencing any decline in HbA1c (63 vs. 69%, P = 0.87); among these patients experiencing a decline, the most substantial reductions were seen with the control group, which had a 13.3% (1.15% absolute) decline compared with the intervention patients, who reduced their HbA1c by 24.2% (2.26% absolute reduction; P = 0.0048). At study close, 77% of the patients had their poster displayed on their refrigerator. CONCLUSIONS—This unique and personalized computer-generated intervention resulted in HbA1c lowering comparable to that of hypoglycemic agents.