Curtiss B. Cook|Robert H. Lyles|Imad M. El?Kebbi|David C. Ziemer|Daniel L. Gallina|Virginia G. Dunbar|Lawrence Phillips
The Potentially Poor Response to Outpatient Diabetes Care in Urban African-Americans
Emory University|Grady Health System|Emory University|Grady Health System|Emory University|Grady Health System|Emory University|Grady Health System|Grady Health System|Emory University|Emory University|Grady Health System|Emory University|Grady Health System
objective hbalc levels reduced populations diabetic patients individuals may exhibit little improvement search reasons underlying differences hbalcoutcome analyzed patients managed outpatient diabetes clinic research design methods africanamericans type 2 diabetes categorized responders intermediate responders poor responders according hbalc level 1 year care logistical regression used determine baseline characteristics distinguished poor responders responders therapeutic strategies examined response categories results 447 patients mean age disease duration 58 5 years respectively bmi 32 kgm2 overall mean hbalc level fell 96 81 12 months mean hbalc levels improved 88 62 responders 95 79 intermediate responders poor responders average hbalc level 108 presentation 109 1 year odds poor responder significantly increased longer disease duration higher initial hbalc level greater bmi although doses oral agents insulin significantly higher among poor responders visits acceleration insulin therapy occur late followup period conclusions clinical diabetes programs need devise methods identify patients risk persistent hyperglycemia whereas patient characteristics explain heterogeneity hbalc outcomeand may aid earlier identification patients potentially may respond conventional treatment insufficient intensification therapy may also component underlying failure achieve glycemic goals