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These Factors Blunt the Impact of T2D Treatment

Diabetes Care; ePub Dec 16; Hirsch, Durden, et al

Certain community factors impacted HbA1c change and reduced treatment intensification effectiveness in people with diabetes in a study involving >15,300 individuals. Participants had type 2 diabetes with an HbA1c ≥7.5% at baseline. Investigators looked at how specific community factors impacted HbA1c change over 6 and 24 months. Among the results:

  • HbA1c was lowered by an average of 0.07% over 6 months in areas with high community socioeconomic deprivation (CSD).
  • Reductions were 0.10% greater in areas with the best vs worst food availability.
  • Reductions were ~0.18% greater in areas in the second and third quartiles of utilitarian physical activity favorability, vs those in the first quartile.
  • Treatment intensification had less of an impact on 6-month HbA1c change in areas with the worst vs best CSD.
  • Treatment intensification had less of an impact on 24-month HbA1c change in areas with the worst CSD, vs those in the third quartile.
  • It was strongest in areas most favorable for utilitarian physical activity (vs the worst).

Citation:

Hirsch A, Durden T, Nordberg C, Berger A, Schwartz B. Associations of four community factors with longitudinal change in hemoglobin A1c levels in patients with type 2 diabetes. [Published online ahead of print December 16, 2017]. Diabetes Care. doi:10.2337/dc17-1200.

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