Impact and significance of a multidisciplinary approach to Type II diabetes in a primary care setting
In the past twenty years, research on the causes and complications of diabetes in the United States has flourished, yet diabetes remains a huge problem. Diabetes is actually becoming more common in the United States even though it is known to be a risk factor for multiple diseases. The number of Americans with diabetes has almost quadrupled from 1980 to 2011, with 5.6 million cases of diagnosed diabetes in 1980 and 20.9 million cases of diagnosed diabetes in 2011.6 As diabetes remains such a public health burden, the purpose of this secondary analysis is to determine whether a twelve-week, primary physician lead, multidisciplinary diabetes management program will lead to an improvement in weight, Body Mass Index (BMI), Hemoglobin A1C (HgbA1C), fasting blood glucose (FBG), High Density Lipoprotein (HDL), and Low Density Lipoprotein (LDL) levels among the program participants. All data used in this secondary analysis will come from a diabetes management program conducted at the Texas Children's Hospital Employee Health and Wellness Center by Texas Children's Hospital in Houston, Texas. Participants received individualized treatment from a primary physician, Dr. William B. Perkison, as well as group education sessions conducted by a registered dietitian. These sessions included education regarding diabetes management, nutrition and exercise, and coping mechanisms. All biometric measurements were taken at the beginning of the program and after completion of the 3-month program. The differences between these measurements will be analyzed. The outcomes of this data analysis will be continuous, and include weight, BMI, HgbA1C, FBG, HDL, and LDL levels. Analysis of Covariance (ANCOVA) will be used to determine pre and post program changes in the intervention and control groups, and will be adjusted for baseline and age. The results of unpaired t-test to evaluate the differences between intervention and control groups for each of the variables at baseline showed none of the p-values were less than 0.05, which means the intervention and control group participants did not differ for these variables at baseline. A paired t-test showed a significant decrease in the A1C levels among intervention participants (t = 2.7069; p = 0.0150). ANCOVA univariate analysis found a statistically significant decrease seen in BMI (p = 0.0151); and LDL (p = 0.407), and the ANCOVA multivariate analysis for BMI (p = 0.0281) and LDL (p = 0.0458) was also significant. Overall, the study showed significant positive effects of the TCH employee wellness diabetes management program on patient BMI and LDL. we can conclude participation in a multidisciplinary diabetes management program can produce improvements in patient biometric measures related to Type II diabetes. The final recommendation for this study is to produce a similar RCT in a primary care setting at a much larger scale.
LaBerge, Emily, "Impact and significance of a multidisciplinary approach to Type II diabetes in a primary care setting" (2014). Texas Medical Center Dissertations (via ProQuest). AAI1566342.