Y Groeneveld1, H Petri, J Hermans, M Springer. 1. Department of General Practice, Leiden University Medical Centre, The Netherlands. y.groeneveld@lumc.nl
Abstract
OBJECTIVE: To study differences in diabetes-related parameters in type 2 diabetic patients treated with the support of a Diabetes Service compared to conventional general practice care. DESIGN: Parallel clinical trial with randomisation at practice level. SETTING:Fifteen general practices. PATIENTS: Type 2 diabetic patients, aged < 76 years, treated by a GP. MAIN OUTCOME MEASURES: Level of glycated haemoglobin (HbA1c). RESULTS:246 patients entered the study. Final mean HbA1c of all evaluable patients allocated to the intervention (n = 84) was 7.1+/-1.2%, vs 7.5+/-1.8% in the controls (n = 140) (p = 0.06). Patients who were initially poorly controlled (Fasting Blood Glucose > 10 mmol/l) had a significantly lower final HbA1c if they were in an intervention practice (p=0.001). Fewer patients in intervention practices were referred to hospital specialists (1 vs 14). CONCLUSIONS: Support by the Dutch Diabetes Service did not significantly influence glycated haemoglobin. The subgroup of initially poorly controlled patients developed a significantly lower HbA1c in intervention practices (supported by a Diabetes Service) than in control practices.
RCT Entities:
OBJECTIVE: To study differences in diabetes-related parameters in type 2 diabeticpatients treated with the support of a Diabetes Service compared to conventional general practice care. DESIGN: Parallel clinical trial with randomisation at practice level. SETTING: Fifteen general practices. PATIENTS: Type 2 diabeticpatients, aged < 76 years, treated by a GP. MAIN OUTCOME MEASURES: Level of glycated haemoglobin (HbA1c). RESULTS: 246 patients entered the study. Final mean HbA1c of all evaluable patients allocated to the intervention (n = 84) was 7.1+/-1.2%, vs 7.5+/-1.8% in the controls (n = 140) (p = 0.06). Patients who were initially poorly controlled (Fasting Blood Glucose > 10 mmol/l) had a significantly lower final HbA1c if they were in an intervention practice (p=0.001). Fewer patients in intervention practices were referred to hospital specialists (1 vs 14). CONCLUSIONS: Support by the Dutch Diabetes Service did not significantly influence glycated haemoglobin. The subgroup of initially poorly controlled patients developed a significantly lower HbA1c in intervention practices (supported by a Diabetes Service) than in control practices.
Authors: Shari D Bolen; Apoorva Chandar; Corinna Falck-Ytter; Carl Tyler; Adam T Perzynski; Alida M Gertz; Paulette Sage; Steven Lewis; Maurine Cobabe; Ying Ye; Michelle Menegay; Donna M Windish Journal: J Gen Intern Med Date: 2014-04-15 Impact factor: 5.128
Authors: Michael L Parchman; Jacqueline A Pugh; Steven D Culler; Polly H Noel; Nedal H Arar; Raquel L Romero; Raymond F Palmer Journal: Implement Sci Date: 2008-03-05 Impact factor: 7.327