title: Long-term effects of a diabetes boot cAMP on measures of diabetic care.
abstract: BACKGROUND
  Diabetic patients should receive self-management education to improve self-care and quality of life but are frequently unable to attend such programs because of the time commitment. We instituted an intensive 2-hour Diabetes Boot Camp to provide this education in a condensed time frame. The objective was to determine the long-term effect of the boot camp on mean hemoglobin A1c (HgA1c) levels in patients with diabetes compared to diabetic patients receiving the standard of care.
  
  
  METHODS
  The Diabetes Boot Camp population was defined as all diabetic patients referred to the boot camp from the 10 highest utilizing physicians between August 2009 and August 2010. A control population was randomly selected from these same physicians' diabetic patients during the same period. Baseline and postintervention HgA1c measurements on the same patients in both groups were extracted from the electronic medical record. Subpopulations studied included those with HgA1c ≥9% and <9% at baseline. To evaluate long-term effects, we compared HgA1c levels 3 years later (between July 1, 2012 and December 31, 2012) for all groups.
  
  
  RESULTS
  Using comparison-over-time analysis, the overall boot camp group (n=69) showed a mean decrease in HgA1c from 8.57% (SD ± 2.32%) to 7.76% (SD ± 1.85%) vs an increase from 7.92% (SD ± 1.58%) to 8.22% (SD ± 1.82%) in the control group (n=107, P<0.001). Mean length of follow-up was 3.2 (SD ± 0.54) years.
  
  
  CONCLUSIONS
  An intensive 2-hour multidisciplinary diabetes clinic was associated with significant long-term improvements in glycemic control in diabetic participants of the clinic.
authors.affiliation: Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Deichmann
authors.affiliation: Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Pedro
authors.initials: P
authors.lastname: Cazabon
authors.affiliation: The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Tim
authors.initials: T
authors.lastname: Asher
authors.affiliation: The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: Brian
authors.initials: B
authors.lastname: Cripe
authors.affiliation: Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Griffin
authors.affiliation: Office of Biostatistical Support, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Adriana
authors.initials: A
authors.lastname: Dornelles
authors.affiliation: Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: G Dodd
authors.initials: GD
authors.lastname: Denton
keywords: Diabetes mellitus; hemoglobin A1c; nutrition therapy
references.citation: Diabetes Care. 2012 Dec;35(12):2706-17
references.pmid: 23173140
references.citation: Diabetes Care. 2008 Jan;31 Suppl 1:S61-78
references.pmid: 18165339
references.citation: Hypertension. 2003 Dec;42(6):1206-52
references.pmid: 14656957
references.citation: Ann Intern Med. 2010 Jun 1;152(11):689-96
references.pmid: 20513826
references.citation: Nurs Clin North Am. 2001 Jun;36(2):203-16, vi
references.pmid: 11382560
references.citation: CMAJ. 2011 Feb 8;183(2):E115-27
references.pmid: 21149524
references.citation: Lancet. 2004 May 15;363(9421):1589-97
references.pmid: 15145632
references.citation: Ann Intern Med. 2005 Sep 20;143(6):427-38
references.pmid: 16172441
references.citation: Ochsner J. 2013 Summer;13(2):194-9
references.pmid: 23789004
references.citation: J Am Diet Assoc. 2010 Dec;110(12):1852-89
references.pmid: 21111095
references.citation: Nurse Pract. 2002;Suppl:16-23; quiz 23-4
references.pmid: 11695173
references.citation: Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003638
references.pmid: 15846672
references.citation: South Med J. 1999 Jul;92(7):667-72
references.pmid: 10414474
references.citation: BMJ. 2002 Oct 26;325(7370):925
references.pmid: 12399340
references.citation: Diabetes Care. 2001 Apr;24(4):695-700
references.pmid: 11315833
references.citation: Am J Clin Nutr. 1999 Apr;69(4):632-46
references.pmid: 10197564
references.citation: Diabetes Care. 2010 Jan;33 Suppl 1:S89-96
references.pmid: 20042780
references.citation: Diabetes Care. 2002 Mar;25(3):608-13
references.pmid: 11874956
references.citation: Diabetes Educ. 2011 Sep-Oct;37(5):638-57
references.pmid: 21878591