מתוך medicontext.co.il
LONDON (Reuters Health) – An intervention that combines individualised patient goals with educational and surveillance support for physicians significantly reduces risk factors for complications among patients with type 2 diabetes mellitus, a Danish research team reports.
Dr. Niels de Fine Olivarius, of the University of Copenhagen, and associates recruited general practitioners and randomized 247 to provide structured care and 237 to provide routine care to their patients with diabetes. A total of 459 patients, ages 40 and above and newly diagnosed between 1989 and 1991, received structured care and 415 similar patients received routine care.
As reported in the October 27th issue of the British Medical Journal, structured care included followup every 3 months and establishment of goals for blood glucose concentration, glycated haemoglobin, blood pressure, and lipids. Overweight patients were encouraged to achieve small, realistic weight reductions. In addition, the physicians were given clinical guidelines, annual half-day educational seminars, and annual reports on individual patients.
At the end of 6 years of followup, fasting plasma glucose concentrations were lower in the intervention group compared with the control group, median 7.9 mmol/L versus 8.7 mmol/L (p = 0.0007). Glycated hemoglobin levels were 8.5% and 9.0%, respectively (p < 0.0001), and systolic blood pressures were 145 mm Hg and 150 mm Hg (p = 0.0004).
According to Dr. Simon J. Griffin of the University of Cambridge, UK, the reductions in risk factors translate to a 26% reduced risk of myocardial infarction and an 11.8% reduction in the risk of microvascular complications.
He suggests in an editorial that explanations for these effects include the physicians' setting and reassessment of personalized, realistic goals, as well as greater involvement and satisfaction on the part of patients.
e-Med Tools
קצר קולע וממוקד
e-Med סמינרים
אי-מד תחקירים
Medscape Tools
Journal Club
מרכזי מידע ושירות
Facebook
מידע למפרסם
מאגר תרופות
מאגר אנשי המקצוע
אינדקס שימושי
חדשות משה"ב
eMed HealthClub
מחקרים קליניים
השאירו תגובה
רוצה להצטרף לדיון?תרגישו חופשי לתרום!