Impact of Disease Management Programs on HbA1c Values in Type 2 Diabetes Patients in Germany

Abstract

Background: The aim was to analyze the impact of disease management programs on HbA1c values in type 2 diabetes mellitus (T2DM) patients in Germany.

Methods: This study included 9017 patients followed in disease management programs (DMPs) who started an antihyperglycemic treatment upon inclusion in a DMP. Standard care (SC) patients were included after individual matching (1:1) to DMP cases based on age, gender, physician (diabetologist versus nondiabetologist care), HbA1c values at baseline, and index year. The main outcome was the share of patients with HbA1c <7.5% or 6.5% after at least 6 months and less than 12 months of therapy in DMP and SC groups. Multivariate logistic regression models were fitted with HbA1c level as a dependent variable and the potential predictor (DMP versus SC).

Results: The mean age was 64.3 years and 54.7% of the patients were men. The mean HbA1c level at baseline was equal to 8.7%. In diabetologist practices, 64.7% of DMP patients and 55.1% of SC patients had HbA1c levels <7.5%, while 23.4% of DMP patients and 16.9% of SC patients had HbA1c levels <6.5% ( P values < .001). By comparison, in general practices, 72.4% of DMP patients and 65.7% of SC patients had HbA1c levels <7.5%, while 29.0% of DMP patients and 25.4% of SC patients had HbA1c levels <6.5% ( P values < .001). DMPs increased the likelihood of HbA1c levels lower than 7.5% or 6.5% after 6 months of therapy in both diabetologist and general care practices.

Conclusion: The present study indicates that the enrollment of T2DM patients in DMPs has a positive impact on HbA1c values in Germany.

Keywords: DMP; HbA1c; disease management program; type 2 diabetes.

Figure 1.

Proportion of patients with HbA1c values lower than 7.5% or 6.5% after 6 months of therapy in German diabetologist practices. DMP, disease management program; SC, standard care.

Figure 2.

Share of patients with HbA1c values lower than 7.5% or 6.5% after 6 months of therapy in German GP practices. DMP, disease management program; SC, standard care.