Diabetes Care Strategies: Finding and Future Research

Armen Hareyan's picture

The Researchers at the Stanford University-University of California at San Francisco Evidence-based Practice Center (EPC) concluded that using at least two quality improvement strategies provides a greater chance for success in controlling patient blood sugar levels than does using a single QI strategy. The same holds true, though to a lesser extent, for physician and care provider adherence to established best practice treatment guidelines. Providers who use a combination of two or more quality improvement strategies are more likely to conform to the highest standard of care in the treatment of patients with diabetes than are providers who rely on a single QI strategy. Based on a small number of studies, the researchers also did not find added benefit from the use of a clinical information system.

At the same time, this study was unable to recommend any one quality improvement strategy as being clearly better than others in its approach to treating diabetes, or to the degree by which it improves patient outcomes.

The conclusions of the EPC literature survey are complicated by differences in the design of the various studies reported in the journal articles. In some cases, the reviewed studies that involved a small number of subjects reported a greater effect than did larger, better-designed studies of the same strategies. None of the articles described studies in which the change in treatment approach had no statistically significant effect. This suggests that the size of the effects of some QI strategies may have been overestimated because researchers and journals are more likely to publish studies showing a positive result, an effect called publication bias.

Future Research Diabetes Care Strategies


There is a rich body of clinical evidence supporting current diabetes treatment methods, but the set of studies designed to help providers, patients, and policymakers improve the standard of care is not as strong. The quality improvement studies analyzed in this report provide some direction, in terms of techniques for improving disease management and implementing best practices. But more research is needed if we are to close the quality gap and reduce the impact of this pervasive health threat.

AHRQ researchers and others throughout the health care community are continuing their investigations into strategies for improving patient outcomes. Those involved with this Technical Review series hope it will generate new ideas to increase the adoption of evidence-based clinical practices, while stimulating new studies and more advanced explorations into high-quality and affordable health care.


The source of this article is http://www.ahcpr.gov


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