Does intervention by the dietitian and diabetes educator of a More Allied Health Services program improve glycosylated haemoglobin levels for those with type 2 diabetes? Implications for rural dietetic practice

The present study aimed to investigate the effect of the number and intensity of visits to the More Allied Health Services (MAHS) clinics and a change in glycosylated haemoglobin (HbA(1)c) levels in people with type 2 diabetes. Data on subjects accessing diabetes clinics in rural southern New South Wales were analysed retrospectively. Data included age at the end of the data collection period, sex, number and dates of visits to the MAHS dietitian and diabetes educator, weights and heights, HbA(1)c and cholesterol levels. Sixty-four patient records were analysed. The median period of clinic attendance was 32.5 months; median number of combined visits to MAHS dietitian and diabetes educator was three. Older subjects were significantly more likely to show a reduction in HbA(1)c than younger subjects. Subjects visiting the MAHS program more regularly than once every eight months were significantly more likely to achieve a reduction in HbA(1)c than those who were seen by MAHS staff once every eight months or more. Sixty per cent of those subjects with four or more visits to the MAHS program showed a reduction in HbA(1)c, while 38% of those with fewer than four visits showed a reduction in HbA(1)c, but this association did not reach significance. Older subjects and those attending the MAHS diabetes clinics more intensively were significantly more likely to show a reduction in HbA(1)c than younger subjects and those attending the clinic once every eight months or more. Future, larger studies using additional outcome measures will allow for an improved evaluation of interventions by dietitians and diabetes educators for those with type 2 diabetes.