title: An internet-based diabetes management platform improves team care and outcomes in an urban Latino population.
abstract: OBJECTIVE
  To compare usual diabetes care (UDC) to a comprehensive diabetes care intervention condition (IC) involving an Internet-based "diabetes dashboard" management tool used by clinicians.
  
  
  METHODS
  We used a parallel-group randomized design. Diabetes nurses, diabetes dietitians, and providers used the diabetes dashboard as a clinical decision support system to deliver a five-visit, 6-month intervention to 199 poorly controlled (HbA1c >7.5% [58 mmol/mol]) Latino type 2 diabetic (T2D) patients (mean age 55 years, 60% female) at urban community health centers. We compared this intervention to an established, in-house UDC program (n = 200) for its impact on blood glucose control and psychosocial outcomes.
  
  
  RESULTS
  Recruitment and retention rates were 79.0 and 88.5%, respectively. Compared with UDC, more IC patients reached HbA1c targets of <7% (53 mmol/mol; 15.8 vs. 7.0%, respectively, P < 0.01) and <8% (64 mmol/mol; 45.2 vs. 25.3%, respectively, P < 0.001). In multiple linear regression adjusting for baseline HbA1c, adjusted mean ± SE HbA1c at follow-up was significantly lower in the IC compared with the UDC group (P < 0.001; IC 8.4 ± 0.10%; UDC 9.2 ± 0.10%). The results showed lower diabetes distress at follow-up for IC patients (40.4 ± 2.1) as compared with UDC patients (48.3 ± 2.0) (P < 0.01), and also lower social distress (32.2 ± 1.3 vs. 27.2 ± 1.4, P < 0.01). There was a similar, statistically significant (P < 0.01) improvement for both groups in the proportion of patients moving from depressed status at baseline to nondepressed at follow-up (41.8 vs. 40%; no significance between groups).
  
  
  CONCLUSIONS
  The diabetes dashboard intervention significantly improved diabetes-related outcomes among Latinos with poorly controlled T2D compared with a similar diabetes team condition without access to the diabetes dashboard.
authors: Behavioral Medicine Research, Baystate Medical Center, Springfield, MA garry@silverfernhealthcare.com.
authors: Garry
authors: G
authors: Welch
authors: Behavioral Medicine Research, Baystate Medical Center, Springfield, MA.
authors: Sofija E
authors: SE
authors: Zagarins
authors: Behavioral Medicine Research, Baystate Medical Center, Springfield, MA.
authors: Paula
authors: P
authors: Santiago-Kelly
authors: Behavioral Medicine Research, Baystate Medical Center, Springfield, MA.
authors: Zoraida
authors: Z
authors: Rodriguez
authors: University of Hawaii at Manoa, Honolulu, HI.
authors: Sven-Erik
authors: SE
authors: Bursell
authors: Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA.
authors: Milagros C
authors: MC
authors: Rosal
authors: Joslin Diabetes Center, Boston, MA.
authors: Robert A
authors: RA
authors: Gabbay
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003191:Comprehensive Health Care / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology* / Q000628:therapy*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards; D012648:Self Care / Q000592:standards / Q000706:statistics & numerical data; D059039:Standard of Care; D016896:Treatment Outcome; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D001786:Blood Glucose
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