Health Disparities/ Diabetes Care. Sheldon Greenfield, MD Orange County Diabetes Education Collaborative Conference January 31, 2009. Optimizing the ‘Physician Effect’ on HbA1c levels. Coached Care Team. Quyen Ngo-Metzger, MD, MPH Israel De Alba, MD, MPH Dara Sorkin, PhD
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Sheldon Greenfield, MD
Orange County Diabetes Education Collaborative Conference
January 31, 2009
Using insulin alone
Adherence as instructed
Problems with insulin regimen
Change insulin to rapid acting qd
Use insulin Pen for administration
Stop or reduce insulin; add oral agent
Improve diet, exercises
F-value = 63.1, p<.001
Chi Square = 49.7, p<.001
General health status Outcomes
General health distress
Quality of life
Diabetes specific health status
Diabetes management hassles
Stress managing diabetesDAWN Minority Survey Measures
“During the past 4 weeks, how much of a problem or hassle has each of the following been for you in your everyday life?”
(A major hassle No hassle at all)
h. Having to keep your schedule (eating, drugs, exercise) in mind all the time…..
“Sometimes diabetes can be a source of frustration to those who have it. During the past 4 weeks, how often:
(All of the time None of the time) a. Were you frustrated about diabetes?....
“Sometimes people with diabetes have concerns about complications that may develop. How much are you worried or concerned about each of the following?”
(Extremely worried Not worried at all) a. Losing my eyesight from diabetes?....
“Overall, how much of a burden is your having diabetes on you and your family in each of the following areas?”
(Very great burden No burden at all)