Journal Article

The impact of free medical supplies and regular telephonic contact on glycemic control in Indian children and adolescents with type 1 diabetes

Sudhanshu, Siddhnath, Arora, Pratibha, Chen, Yanjun, Dabadghao, Preeti, Bano, Sayda, Mangla, Pragya, Bhatia, Eesh, Bhatia, Vijayalakshmi, Chopra, Aditi

2019

Overview

Background/Objective The effect of economic assistance to underprivileged families with type 1 diabetes has never been described. Such a study is relevant as logistic and cultural factors may preclude an anticipated good outcome. The objective of the study is to determine the impact of economic and educational intervention on hemoglobin A1c (HbA1c) and diabetes knowledge. Methods Eighty‐five consecutive participants were prospectively provided insulin and glucose strips for 1 year. From the 6th to 12th month, patients were randomized such that half of them (telephone group) received proactive telephonic advice by a diabetes educator, while the non‐telephone group received usual care. HbA1c and diabetes knowledge were measured at baseline, 6 and 12 months. Results Significant improvement was seen in HbA1c with provision of free diabetes supplies, when patients were compared with their own HbA1c values during the prior 36 months (baseline [8.38 ± 2.0%], at 3 months [8.0 ± 1.6%] and at 6 months [8.1 ± 1.5%, P = 0.0106]). Knowledge score increased from baseline (48 ± 15) to 6 months (58 ± 13, P < 0.001). No difference was seen between the telephone and non‐telephone groups in HbA1c from the 6th to 9th and 12th month. The knowledge score showed significant improvement in the telephone group during the proactive telephonic advice study compared with the non‐telephone group (P = 0.002). Conclusions The provision of free medical supplies improved HbA1c and diabetes knowledge. Intensive telephone contact improved knowledge, not HbA1c. These results provide important background for policy makers and diabetes management teams.

• Publisher: John Wiley & Sons A/S,John Wiley & Sons, Inc
• Subject: Adolescent / Adolescents / Blood Glucose - analysis / Blood Glucose - metabolism / Blood Glucose Self-Monitoring - economics / Blood Glucose Self-Monitoring - instrumentation / Blood Glucose Self-Monitoring - methods / Child / Cohort Studies / Communication / Counseling / Diabetes / Diabetes mellitus / Diabetes mellitus (insulin dependent) / Diabetes Mellitus, Type 1 - blood / Diabetes Mellitus, Type 1 - economics / Diabetes Mellitus, Type 1 - epidemiology / Diabetes Mellitus, Type 1 - therapy / economic / education / Equipment and Supplies - economics / Equipment and Supplies - statistics & numerical data / Equipment and Supplies - supply & distribution / Female / Glucose / Glycated Hemoglobin A - analysis / Glycated Hemoglobin A - metabolism / HbA1c / Health Services Accessibility - economics / Health Services Accessibility - statistics & numerical data / Hemoglobin / Humans / income / India / India - epidemiology / Insulin / Insulin - economics / Insulin - therapeutic use / Knowledge / Male / Medical Assistance - economics / Medical Assistance - statistics & numerical data / Medical supplies / Reagent Strips - economics / Reagent Strips - supply & distribution / Social Class / Surveys and Questionnaires / Teenagers / Telephone - statistics & numerical data / Treatment Outcome