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Background  Numerous primary care innovations emphasize patient-centered processes of care. Within the context of these innovations, greater understanding is needed of the relationship between improvements in clinical endpoints and patient-centered outcomes. To address this gap, we evaluated the association between glycosylated hemoglobin (HbA 1c ) and diabetes-specific quality of life among patients completing diabetes self-management programs.    Methods  We conducted a retrospective cohort study nested within a randomized comparative effectiveness trial of diabetes self-management interventions in 75 diabetic patients. Multiple linear regression models were developed to examine the relationship between change in HbA 1c  from baseline to one-year follow-up and Diabetes-39 (a diabetes-specific quality of life measure) at one year.    Results  HbA 1c  levels improved for the overall cohort from baseline to one-year follow-up ( t  (74) = 3.09,  p  = .0029). One-year follow up HbA 1c  was correlated with worse overall quality of life ( r  = 0.33,  p  = 0.004). Improvements in HbA 1c  from baseline to one-year follow-up were associated with greater D-39 diabetes control ( β  = 0.23,  p  = .04) and D-39 sexual functioning ( β  = 0.25,  p  = .03) quality of life subscales.    Conclusions  Improvements in HbA 1c  among participants completing a diabetes self-management program were associated with better diabetes-specific quality of life. Innovations in primary care that engage patients in self-management and improve clinical biomarkers, such as HbA 1c , may also be associated with better quality of life, a key outcome from the patient perspective.

health and quality of life outcomes

Hemoglobin A1c improvements and better diabetes-specific quality of life among participants completing diabetes self-management programs: A nested cohort study