„Diabetes in Germany” (DIG)-Studie

Ott, P.; Benke, I.; Stelzer, John W.; Köhler, C; Hanefeld, Markolf

doi:10.1055/s-0028-1123994

Cited by 17 publications

(14 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Best et al reported over the course of 5 years, GHb increased by an average of 0.22% in patients with type 2 diabetes [19]. Ott et al in diabetes in Germany study reported that mean GHb was 6.98% at base line and 7.03% at the study end and increased by an average of 0.05% over 3.7 years [20]. However, their study populations are very different with present study in regard to age, gender, race, methodology, access to medical care, and genetic background.…”

Section: Discussionmentioning

confidence: 99%

Patterns and Predictors of Long-Term Glycemic Control in Patients with Type 2 Diabetes

Janghorbani

Amini

2012

ISRN Endocrinology

View full text Add to dashboard Cite

Aims/Introduction. To describe patterns of long-term glycemic control among patients with type 2 diabetes in Isfahan, Iran and identify factors associated with glycemic control. Methods. During the mean (standard deviation (SD)) follow-up period of 8.4 (4.2) (range 1–18) years, 4,582 patients with type 2 diabetes have been examined to determine glycemic changes. Their glycated hemoglobin (GHb) at the last clinic visit was compared with the initial visit data. The mean (SD) age of participants was 49.3 (9.6) years with a mean (SD) duration of diabetes of 5.0 (5.1) years at initial registration. Results. Mean (SD) GHb was 8.7% (2.3) at baseline and 7.9% (1.9) at the study end and decreased by mean of 0.8% (95% confidence interval (CI) 0.74, 0.87; P < 0.001) and varied by the severity of baseline GHb. 74.6% at the initial visit versus 64.4% at the last clinic visit had GHb values above the target level of 7.0%. Using a stepwise multiple regression models, age, higher GHb, FPG, follow-up period, and number of follow-up visits increased and higher systolic BP and female gender significantly decreased the percent glycemic change. Conclusions. This study highlights that more than 64.4% of the patients have GHb values higher than 7.0% at last clinic visit andindicatesthe difficult challenges physicians face when treating their patients with type 2 diabetes. Clinical efforts should focus on more effective methods for glycemic control in diabetic patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Patterns and Predictors of Long-Term Glycemic Control in Patients with Type 2 Diabetes

Janghorbani

Amini

2012

ISRN Endocrinology

View full text Add to dashboard Cite

show abstract

“…Based on previous data and on our inclusion criteria (HbA1c > 7.0%) we assumed a mean HbA1c of 7.7% at pre-data-measurement time and aimed at a reduction in the HbA1c of 0.5% points with the intervention. In accordance to the data from the "Diabetes in Germany" (DIG)-study [49] and the ACCORD trial [50], the SD was assumed to be 1.2. The power was defined as 80%.…”

Section: Methodsmentioning

confidence: 99%

The Chronic CARe for diAbeTes study (CARAT): a cluster randomized controlled trial

Frei

Chmiel

Schläpfer³

et al. 2010

Cardiovasc Diabetol

View full text Add to dashboard Cite

BackgroundDiabetes is a major challenge for the health care system and especially for the primary care provider. The Chronic Care Model represents an evidence-based framework for the care for chronically ill. An increasing number of studies showed that implementing elements of the Chronic Care Model improves patient relevant outcomes and process parameters. However, most of these findings have been performed in settings different from the Swiss health care system which is dominated by single handed practices.Methods/DesignCARAT is a cluster randomized controlled trial with general practitioners as the unit of randomization (trial registration: ISRCTN05947538). The study challenges the hypothesis that implementing several elements of the Chronic Care Model via a specially trained practice nurse improves the HbA1c level of diabetes type II patients significantly after one year (primary outcome). Furthermore, we assume that the intervention increases the proportion of patients who achieve the recommended targets regarding blood pressure (<130/80), HbA1c (=<6.5%) and low-density lipoprotein-cholesterol (<2.6 mmol/l), increases patients' quality of life (SF-36) and several evidence-based quality indicators for diabetes care. These improvements in care will be experienced by the patients (PACIC-5A) as well as by the practice team (ACIC). According to the power calculation, 28 general practitioners will be randomized either to the intervention group or to the control group. Each general practitioner will include 12 patients suffering from diabetes type II. In the intervention group the general practitioner as well as the practice nurse will be trained to perform care for diabetes patients according to the Chronic Care Model in teamwork. In the control group no intervention will be applied at all and patients will be treated as usual. Measurements (pre-data-collection) will take place in months II-IV, starting in February 2010. Follow-up data will be collected after 1 year.DiscussionThis study challenges the hypothesis that the Chronic Care Model can be easily implemented by a practice nurse focused approach. If our results will confirm this hypothesis the suggestion arises whether this approach should be implemented in other chronic diseases and multimorbid patients and how to redesign care in Switzerland.

show abstract

“…Furthermore there is substantial improvement of glycemic control in the majority of patients in most countries. For example the mean HbA1c in Germany is 7 % [11, 12]. On the other hand patients with diabetes now survive long enough to face diabetes-related complications and increased risk of cancer.…”

Section: Glucose Centered Randomized Clinical Trialsmentioning

confidence: 99%

Insulin Use Early in the Course of Type 2 Diabetes Mellitus: The ORIGIN Trial

Hanefeld

Bramlage

2013

Curr Diab Rep

View full text Add to dashboard Cite

There has been a recent shift from a uniform treatment targeting HbA1c to a patient centered approach due to disappointing results of intensified glucose control in mega-trials such as VADT, ADVANCE, and ACCORD. In addition, morbidity and mortality has been substantially reduced since the UKPDS leading to an overestimation of the absolute risk for cardiovascular complications in randomized controlled trials. With substantial progress in prevention of cardiovascular complications, patients with type 2 diabetes now survive long enough to face diabetes-related complications and cancer risk. This requires rethinking of antidiabetic treatment strategies as exemplified by a recent consensus statement of the EASD and ADA, calling for a more patient centered treatment. Within this context the value of early insulin initiation was reinforced, the clinical utility of which has been demonstrated in the recent ORIGIN trial. ORIGIN demonstrated neutral results for the primary endpoint, but reduced microangiopathy in patients with an HbA1c value of ≥6.4 % with basal insulin glargine. After 5 years of follow-up 77 % of the patients in the glargine arm and 66 % with standard care remained at an HbA1c <7 %. An ongoing long-term follow-up (ORIGINALE) will clarify whether this also translates into a reduction of macrovascular events and mortality.

show abstract

„Diabetes in Germany” (DIG)-Studie

Cited by 17 publications

References 26 publications

Patterns and Predictors of Long-Term Glycemic Control in Patients with Type 2 Diabetes

Patterns and Predictors of Long-Term Glycemic Control in Patients with Type 2 Diabetes

The Chronic CARe for diAbeTes study (CARAT): a cluster randomized controlled trial

Insulin Use Early in the Course of Type 2 Diabetes Mellitus: The ORIGIN Trial

Contact Info

Product

Resources

About