Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct 30;9(11):igaf121.
doi: 10.1093/geroni/igaf121. eCollection 2025.

Age-related variations in HbA1c improvements: insights from a telehealth-supported community-based intervention

Laura Porterfield  1   2 , Xiaoying Yu  3 , Amber B Amspoker  4   5 , Craig A Johnston  6 , Aanand D Naik  7 , Salim S Virani  8   9 , Christie M Ballantyne  4 , Ashok Balasubramanyam  4 , Elizabeth M Vaughan  4   10
Affiliations

Age-related variations in HbA1c improvements: insights from a telehealth-supported community-based intervention

Laura Porterfield et al. Innov Aging. .

Abstract

Background and objectives: We previously demonstrated that a telehealth-supported community health worker (CHW) intervention significantly improved clinical outcomes in diabetes care. However, the extent to which these benefits vary across different age groups remains unclear. This study evaluated the effectiveness of a CHW-led multidimensional diabetes intervention in reducing HbA1c across age groups.

Research design and methods: We conducted a retrospective analysis of 10 studies (n = 301) that focused on low-income Hispanic adults with or at risk for type 2 diabetes. The intervention included CHW-participant coaching via mobile Health (mHealth), monthly CHW-led group education, and bidirectional mHealth feedback among participants, CHWs, and clinicians. Outcomes included HbA1c changes from baseline to 6 months and an analysis of CHW-participant conversation data.

Results: HbA1c levels improved across all age groups from baseline to 6 months, with statistically significant reductions observed in individuals aged 40-66 years (p < .05). As age increased from 40 to 49 years (n = 78), HbA1c reductions ranged from -0.83% to -1.18% (p = .013 to p < .001). By age 50-65 years (n = 182), the trend reversed, with smaller improvements observed as age increased (-1.16% to -0.61%, p < .001 to p = .016). Beyond 65 years (n = 27), HbA1c changes plateaued and were not statistically significant. Medication-related concerns were more prevalent among adults ≥65 years (73.7%) compared to those <65 years (44.1%) (p = .014).

Discussion and implications: HbA1c improved across all ages except in older adults, suggesting that age may play a role in intervention effectiveness. Targeted strategies and further research are needed to understand and address these age-related differences.

Keywords: Community health workers; Diabetes; Group education; Minority health; Telehealth.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Estimated age-specific HbA1c changes baseline to 6 months, with 95% confidence intervals.
Figure 2.
Figure 2.
Estimated age-specific HbA1c changes from baseline to study endpoint (6, 12, or 15 months), with 95% confidence intervals.
See this image and copyright information in PMC

References

    1. World Health Organization. Diabetes: Key Facts. 2024. https://www.who.int/news-room/fact-sheets/detail/diabetes?utm_source=cha.... Accessed February 10, 2025.
    1. Centers for Disease Control and Prevention. National Diabetes Statistics Report. 2024. https://www.cdc.gov/diabetes/php/data-research/index.html. Accessed February 10, 2025.
    1. Gandhi GY, Mooradian AD. Management of hyperglycemia in older adults with type 2 diabetes. Drugs & Aging. 2022;39:39-58. 10.1007/s40266-021-00910-1 - DOI - PubMed
    1. Capoccia K, Odegard PS, Letassy N. Medication adherence with diabetes medication: a systematic review of the literature. Diabetes Educator. 2015;42:34-71. 10.1177/0145721715619038 - DOI - PubMed
    1. Misra S, Ke C, Srinivasan S, et al. Current insights and emerging trends in early-onset type 2 diabetes. Lancet Diabetes Endocrinol. 2023;11:768-782. 10.1016/S2213-8587(23)00225-5 - DOI - PubMed