title: Effect of computer-generated tailored feedback on glycemic control in people with diabetes in the community: a randomized controlled trial.
abstract: OBJECTIVE
  It is unknown whether computer-generated, patient-tailored feedback leads to improvements in glycemic control in people with type 2 diabetes.
  
  
  METHODS
  We recruited people with type 2 diabetes aged ≥ 40 years with a glycated hemoglobin (A1C) ≥ 7%, living in Hamilton, Canada, who were enrolled in a community-based program (Diabetes Hamilton) that provided regular evidence-based information and listings of community resources designed to facilitate diabetes self-management. After completing a questionnaire, participants were randomly allocated to either receive or not receive periodic computer-generated, evidence-based feedback on the basis of their questionnaire responses and designed to facilitate improved glycemic control and diabetes self-management. The primary outcome was a change in A1C after 1 year.
  
  
  RESULTS
  A total of 465 participants (50% women, mean age 62 years, and mean A1C 7.83%) were randomly assigned, and 12-month A1C values were available in 96% of all participants, at which time the A1C level had decreased by an absolute amount of 0.24 and 0.15% in the intervention and control groups, respectively. The difference in A1C reduction for the intervention versus control group was 0.09% (95% CI -0.08 to 0.26; P = 0.3). No between-group differences in measures of quality of life, diabetes self-management behaviors, or clinical outcomes were observed.
  
  
  CONCLUSIONS
  Providing computer-generated tailored feedback to registrants of a generic, community-based program that supports diabetes self-management does not lead to lower A1C levels or a better quality of life than participation in the community-based program (augmented by periodic A1C testing) alone.
authors.affiliation: School of Nursing, McMaster University, Hamilton, Ontario, Canada. dsherif@mcmaster.ca
authors.forename: Diana
authors.initials: D
authors.lastname: Sherifali
authors.forename: Janet L
authors.initials: JL
authors.lastname: Greb
authors.forename: Gaya
authors.initials: G
authors.lastname: Amirthavasar
authors.forename: Dereck
authors.initials: D
authors.lastname: Hunt
authors.forename: R Brian
authors.initials: RB
authors.lastname: Haynes
authors.forename: William
authors.initials: W
authors.lastname: Harper
authors.forename: Anne
authors.initials: A
authors.lastname: Holbrook
authors.forename: Sarah
authors.initials: S
authors.lastname: Capes
authors.forename: Ron
authors.initials: R
authors.lastname: Goeree
authors.forename: Daria
authors.initials: D
authors.lastname: O'Reilly
authors.forename: Eleanor
authors.initials: E
authors.lastname: Pullenayegum
authors.forename: Hertzel C
authors.initials: HC
authors.lastname: Gerstein
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000187:drug effects; D003201:Computers; D003920:Diabetes Mellitus / Q000097:blood* / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents