Mobile care teams improve metabolic control for adults with Type II diabetes in the Southern West Bank, Palestine

Aim: The purpose of this study is to assess the effectiveness of the Diabetes Comprehensive Care Model (DCCM) intervention on diabetes care outcomes. We hypothesized that participants receiving diabetes care from the mobile diabetes clinic (intervention group) would demonstrate significant improvement in glycemic control compared to those receiving treatment as usual (control group). Materials and methods: We conducted a longitudinal, quasi-experimental study in which two similar clinics were identified. From both, we recruited 100 patients diagnosed with Type II diabetes. At baseline, patients were similar in terms of both socio-demographic and diabetes health variables. The team visited patients at the Bethlehem clinic at the beginning and end of the study (control group). Mobile diabetes care teams implemented the DCCM in Hebron four times over one year (treatment group). Results: Most participants were female (63.5%) with average diabetes duration of 7.9 years. Initial HbA1c was 9.49% on average (SD = 1.93) and 9.20% (SD = 1.92) for the control and intervention groups, respectively. Statistically significant change in HbA1c, cholesterol, creatinine and systolic BP were observed in the intervention group (differences in change between recruitment and follow-up). That is, significant improvement over time was observed for the treatment group whereas little or no change was observed for the control group. Conclusion: The DCCM-based intervention leads to improved glycemic control parameters indicative of diabetes control. Clinically significant change was observed in treatment group only. Integrative diabetes care appears especially well suited for fragmented healthcare systems with limited resources.