An assessment of structured care assistance in the management of patients with type 2 diabetes in general practice

Abstract

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.

Interventions in primary care to improve cardiovascular risk factors and glycated haemoglobin (HbA1c) levels in patients with diabetes: a systematic review

“…The majority of included studies were randomized controlled trials [27–45] and (cluster‐)randomized controlled trials [26,46–83], with nine controlled before‐and‐after studies [84–92], and one controlled clinical trial [93] (Tables S1 and S2). Studies were mostly conducted in the United States (n = 26) [28,31,32,35–40,44,45,51,52,55,57,58, 60,64,65,68,69,73,75,82,83,93], UK (n = 14) [27,29,34,42,46, 47,54,61,67,74,77,78,81,92] and The Netherlands (n = 11) [30,43,49,63,66,70,79,84,86,89,91]. Settings were PC practices or general practices, although 20 (PC or general medicine) clinics [28,31,36–38,41,44,45,50,52,55,57,58,64,72,76,87,88,93] and two studies on collaboration between hospitals/clinics and PC [32,33] were included as well.…”

“…In 17 studies, there was a statistically significant improvement in HbA1c [26,29,31,35,39,40,44,57,59,60,62,72,79,84,86,90,92]. BP, systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) were assessed in 32 studies [26,29,32,33,39–41,46, 50,52,55,57,59–62,66,69,70,72–74,77,78,80,84,86,88–91]. Eleven studies showed statistically significant improvements in at least one of these measures [26,32,39–41,50,60,66,70,77, 86,90]. In 8 [29,60,66,72,77,84,86,88,91] of the 33 studies [26,28,29,32,35,38,41,50–52,55,57,59–62,66,69,70,72–74, 77,80,82–84,86,88–91] evaluating cholesterol, low‐density lipoprotein cholesterol (LDL) and/or high‐density lipoprotein cholesterol (HDL), a statistically significant improvement in at least one of these outcomes was reported.…”

Individual influences on lifestyle change to reduce vascular risk: a qualitative literature review

“…Despite the paucity of trials evidence, there is a strong rationale and some evidence to support more tailored approaches to lifestyle behaviour change. [53][54][55] What might an effective programme look like? The present study identified both practical and psychological influences on behaviour change, indicating the need for a broad approach to lifestyle assessment and delivery of support.…”

Dysbiosis of urinary microbiota is positively correlated with Type 2 diabetes mellitus

“…Additionally, FBG was measured on the same day as urine sample collection. After the participants were recruited into the HC or T2DM cohort, T2DM patients were divided into two subgroups: FBG ≤ 10 mmol/L group (well controlled group) and FBG > 10 mmol/L group (poor controlled group) [53]. A self-report questionnaire was used to collect demographic characteristics, and the Chinese Food Frequency Questionnaire was used to examine water intake [54].…”