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).
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.