title: Is the physical functioning of older adults with diabetes associated with the processes and outcomes of care? Evidence from Translating Research Into Action for Diabetes (TRIAD).
abstract: OBJECTIVE
  To examine the relationship between physical function limitations and diabetes self-management, processes of care and intermediate outcomes in adults ≥ 65 years of age with Type 2 diabetes.
  
  
  METHODS
  We studied 1796 participants 65 years of age and older in managed care health plans enrolled in Translating Research into Action for Diabetes (TRIAD). Physical functioning was assessed at baseline with the Physical Component Summary of the Short Form-12 Health Survey. Diabetes self-management was assessed with follow-up surveys, and processes of care (eye examinations, urine microalbumin testing, foot examinations, etc.) and intermediate health outcomes (HbA(1c), blood pressure, LDL cholesterol) were assessed with medical chart reviews. Multivariate regression models were constructed to examine the associations between physical function limitations and outcomes.
  
  
  RESULTS
  Frequency of eye examinations (odds ratio 0.69, 95% CI 0.49-0.99) was the only process of care that was worse for participants with physical function limitations (n = 573) compared with those without limitations (n = 618). Neither self-management nor intermediate outcomes differed by whether patients had or did not have physical function limitations.
  
  
  CONCLUSIONS
  Limitations in physical functioning as assessed by the Short Form-12 were not associated with substantial difference in diabetes care in adults ≥ 65 years of age enrolled in managed care health plans.
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. pearllee@umich.edu
authors.forename: P G
authors.initials: PG
authors.lastname: Lee
authors.forename: L N
authors.initials: LN
authors.lastname: McEwen
authors.forename: B
authors.initials: B
authors.lastname: Waitzfelder
authors.forename: U
authors.initials: U
authors.lastname: Subramanian
authors.forename: A J
authors.initials: AJ
authors.lastname: Karter
authors.forename: C M
authors.initials: CM
authors.lastname: Mangione
authors.forename: W H
authors.initials: WH
authors.lastname: Herman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D009043:Motor Activity / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012044:Regression Analysis; D012648:Self Care; D014481:United States