Diabetics get on-site coaching at Michigan Chrysler plant

Key Points

A 14-month pilot program at Chrysler's Sterling Heights, Mich., assembly plant suggests that getting job-site coaching from a pharmacist or dietitian helps workers control their diabetes.

The assembly plant program ended this past April. Follow-up data showed participants, on average, lowered their glycosylated hemoglobin (HbA_1c) level by 1.3 percentage points. According to Roger P. Austin, clinical pharmacy specialist at the Henry Ford Health System (HFHS) in Detroit, the plant's workers also had an average decrease of 56.8 mg/dL in their random blood glucose levels and improved their blood pressure and cholesterol profiles.

The assembly plant program was a joint project of the automaker, HFHS, and the health system's nonprofit subsidiary, the Health Alliance Plan. Austin, who worked with HFHS dietitians at the auto plant, described the project and its results at the annual meeting of the American Association of Diabetes Educators in Washington, D.C.

Seventy workers enrolled in the program and 34 completed it, attending at least five one-on-one counseling sessions. Aggregate data from before and after the intervention were obtained for 22 participants.

Austin emphasized that the assembly plant program was not a randomized, controlled trial. Nonetheless, he said, the change in average HbA1c values, which fell to 7.2 percent from a baseline average of 8.5 percent, was "pretty amazing."

According to a Chrysler spokesman, the Sterling Heights program was modeled after Driving DCX, a diabetes management program at Chrysler's headquarters in Auburn Hills, Mich. Under the Driving DCX model, workers signed up for six one-on-one coaching sessions with an HFHS diabetes educator to identify personal goals for improving their blood glucose levels through diet and medication management.

At Chrysler headquarters, 160 employees participated in the program, which ran from August 2005 to February 2006. Austin said HFHS still holds a monthly workplace diabetes clinic at the headquarters location.

Austin said he would have liked to have more assembly plant workers participate in the program. He noted that the time commitment was difficult for workers to manage in the manufacturing environment. "That was one of the things we really struggled with," he said. Assembly-line workers generally had to schedule clinic appointments for the start or end of their shift. Other workers at the plant, such as pipefitters and electricians, had more flexibility but still needed to work the appointments into their workday.

"When we were at headquarters, we were able to spend as much as an hour with the employees," Austin said. "In the manufacturing environment, we don't have that luxury. We were lucky to get 30 minutes" per session. Even though the enrollment numbers were relatively small, the work-site program led to positive changes for participants." For example, 15 of the assembly plant workers with diabetes were not regularly monitoring their blood glucose levels when they started the program, he said. When they enrolled, these workers received monitors and began to check their blood sugar levels regularly. The program identified one worker with previously undiagnosed diabetes. Two other workers made the decision to start taking insulin, and one employee started using an insulin pump, Austin said.