# Age-related variations in HbA1c improvements: insights from a telehealth-supported community-based intervention

## TL;DR

A telehealth-supported diabetes intervention improved HbA1c levels in most age groups, but older adults over 65 showed less improvement.

## Contribution

This study reveals age-related differences in HbA1c improvements from a telehealth-supported diabetes intervention.

## Key findings

- HbA1c levels significantly improved in individuals aged 40-66 years, with the largest reductions in the 40-49 age group.
- Improvements in HbA1c decreased with increasing age beyond 50 years, with no significant changes observed in those over 65.
- Older adults (≥65 years) reported more medication-related concerns compared to younger participants.

## Abstract

We previously demonstrated that a telehealth-supported community health worker (CHW) intervention significantly improved clinical outcomes in diabetes care. However, the extent to which these benefits vary across different age groups remains unclear. This study evaluated the effectiveness of a CHW-led multidimensional diabetes intervention in reducing HbA1c across age groups.

We conducted a retrospective analysis of 10 studies (n = 301) that focused on low-income Hispanic adults with or at risk for type 2 diabetes. The intervention included CHW-participant coaching via mobile Health (mHealth), monthly CHW-led group education, and bidirectional mHealth feedback among participants, CHWs, and clinicians. Outcomes included HbA1c changes from baseline to 6 months and an analysis of CHW-participant conversation data.

HbA1c levels improved across all age groups from baseline to 6 months, with statistically significant reductions observed in individuals aged 40-66 years (p < .05). As age increased from 40 to 49 years (n = 78), HbA1c reductions ranged from −0.83% to −1.18% (p = .013 to p < .001). By age 50-65 years (n = 182), the trend reversed, with smaller improvements observed as age increased (−1.16% to −0.61%, p < .001 to p = .016). Beyond 65 years (n = 27), HbA1c changes plateaued and were not statistically significant. Medication-related concerns were more prevalent among adults ≥65 years (73.7%) compared to those <65 years (44.1%) (p = .014).

HbA1c improved across all ages except in older adults, suggesting that age may play a role in intervention effectiveness. Targeted strategies and further research are needed to understand and address these age-related differences.