Does a Collaborative Diabetes Management Plan Improve Self-Rated Health? Results from the California Health Interview Survey

Diabetes is a leading cause of death nationally and disproportionately affects people with serious mental illness (SMI). Patient-provider collaboration in diabetes management planning is associated with improved health among individuals with diabetes, but little is known about the effects of such a plan on the health of people with diabetes and SMI. This study aims to 1) Examine the effects of a collaboratively made diabetes management plan on self-rated health of people living with diabetes and SMI, and 2) Compare the effects of a collaborative plan on the health of individuals with SMI and without SMI. Methods: Data were drawn from the 2009 California Health Interview Survey. Logistic regression models were fit to examine the effects of collaborative diabetes management on health, controlling for other aspects of clinical care, lifestyle factors, and demographic characteristics among individuals with diabetes and SMI (n = 235) and without SMI (n =4526). Results: Compared to those without SMI, individuals with SMI were less likely to have a collaborative diabetes care plan (p<0.001). Among individuals without SMI, a collaborative diabetes care plan was associated with increased likelihood of reporting good self-rated health (OR = 1.416; 95% CI =1.042-1.924). Among those with SMI, there was no significant relationship between having a collaborative diabetes care plan and health. Conclusion: Collaboration between patients and health providers is critical to successful diabetes management, but does not sufficiently support diabetes patients with SMI. Policies and services are needed to reduce disparities in health and diabetes management among people with SMI.