'Analogy-Based Comprehensive Diabetes Education' (ABCDE) Improves Glycemic Control of Diabetic Patients in an Underserved Population: Results of a Retrospective Chart Analysis

Abstract

Diabetes is the leading global cause for blindness, kidney failure and amputations. Preventing these complications requires optimal glycemic control, and it is imperative that diabetic patients understand the fundamental concepts of diabetes care. Although patients attend formal diabetes education classes, many do not comprehend basic concepts of diabetes, and are often noncompliant with diet, exercise and medications. A novel approach termed 'analogy-based comprehensive diabetes education' (ABCDE) was developed to educate HIV-patients with diabetes about basic concepts of diabetes care. The object of this manuscript is to report the results of a retrospective chart review on the impact of ABCDE on glycemic outcomes in 24 patients who had failed usual care (including formal diabetes education, physician visits, and diabetic medications), and were non-adherent with diet and medications. They received only the ABCDE without any changes in pharmacotherapy. The impact on glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG) was assessed at subsequent visits. HbA1c was found to decline by 22% and 33% after 3 and 6 months, respectively, with corresponding declines in FBG by 53% and 59%, respectively. These results suggest that ABCDE in outpatient diabetes clinics could be effective in behavior modification toward improving glycemic control, and warrants additional investigation.

Keywords: analogies; diabetes; education; glycemic outcomes.

Figure 1

Improvement in glycosylated hemoglobin (HbA1c) after receiving ABCDE. Visit-1 = first visit where ABCDE was provided; Visit-2 and Visit-3 = visits 3- and 6 months after Visit-1. * = p < 0.00001.

Figure 2

Improvement in estimated average glucose after receiving ABCDE. Visit-1 = first visit where ABCDE was provided; Visit-2 and Visit-3 = visits 3- and 6 months after Visit 1. * = p < 0.00001.

Figure 3

Improvement in glycemic indices after receiving ABCDE. Visit-1 = first visit where ABCDE was provided; Visit-2 and Visit-3 = visits 3- and 6 months after Visit 1. * = p < 0.00001.

Figure 4

Percent decline in glycemic indices after receiving ABCDE. Visit–1 = first visit where ABCDE was provided; Visit-2 and Visit-3 = visits 3- and 6 months after Visit–1. HbA1c = glycosylated hemoglobin, EAG = estimated average glucose, FBG = fasting blood glucose.