title: Diabetes control through an educational intervention.
abstract: OBJECTIVE
  We evaluated the effect of an educational intervention administered to patients or/and physicians on the reduction in HbA(1c) and achieving diabetic control in a high-risk primarily Black inner-city population.
  
  
  METHODS
  The study was designed as a four-arm randomized clinical trial where an educational program on diabetes was offered to physicians only, patients only, and both physicians and their patients, while the fourth arm did not receive any instruction. We built regression models at 24 months of follow-up to assess the likelihood of reaching glycemic goal as well as to measure the absolute reduction in HbA(1c) controlling for arm assignment, insulin use, race, age, sex, smoking, insulin use, and having achieved blood pressure control.
  
  
  RESULTS
  Between April 2005 and July 2007, there were 823 patients randomized into the study. In multivariate analyses, the intervention group in which only patients received education showed a trend toward achieving a significant mean reduction in HbA(1c) with 49% (P = .06) higher odds of reaching glycemic control and .12 (P = .06) greater absolute percentage point drop in HbA(1c) compared to the no education group.
  
  
  CONCLUSIONS
  Although our study reports positive results, it warrants a special emphasis on the behavior of the patient. Study results bring attention to disease management programs such as peer support networks that empower the patients that shift some of the responsibility to them.
authors.forename: Wallace
authors.initials: W
authors.lastname: Johnson
authors.forename: Fadia T
authors.initials: FT
authors.lastname: Shaya
authors.forename: Reed
authors.initials: R
authors.lastname: Winston
authors.forename: Aurelia
authors.initials: A
authors.lastname: Laird
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Mullins
authors.forename: Viktor V
authors.initials: VV
authors.lastname: Chirikov
authors.forename: Elijah
authors.initials: E
authors.lastname: Saunders
mesh_terms: D001741:Black or African American; D000368:Aged; D003920:Diabetes Mellitus / Q000097:blood / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012307:Risk Factors; D014505:Urban Population
chemical_list: D006442:Glycated Hemoglobin