Effects of structured hospital‐based care compared with standard care for Type 2 diabetes—The Asker and Baerum Cardiovascular Diabetes Study, a randomized trial

Johansen, Odd Erik; Gullestad, Lars; Blaasaas, Karl Gerhard; Orvik, Elsa; Birkeland, Kåre I.

doi:10.1111/j.1464-5491.2007.02198.x

Cited by 24 publications

(35 citation statements)

References 37 publications

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“…12 Conversely, increasing the focus on including the spouse might result in a spouse becoming overprotective, which might impact negatively on the patient's self-management of his or her diabetes. 22 The present study and a previous report highlight the need for providing patients and their families with appropriate, practical information about T2DM.…”

Section: Discussionmentioning

confidence: 98%

“…13,14 Inclusion/exclusion criteria and recruitment procedures for this trial have been described previously. 9,12 …”

Section: Study Flowmentioning

confidence: 99%

“…12 CV risk was evaluated by estimating each patient's 10-year absolute risk for coronary heart disease (CHD), using the adult treatment panel's risk estimator from the Framingham heart study. 15 This model is based on an epidemiological study and incorporates several isolated CV risk factors (age, gender, total cholesterol, high-density lipoprotein cholesterol, tobacco use and systolic BP) to predict patients' 10-year absolute risk for CHD; it has been validated for use in people with T2DM.…”

Section: Assessment Of Objective Measures Of Healthmentioning

confidence: 99%

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Spouses’ educational needs and perceptions of health in partners with type 2 diabetes

Orvik

Ribu

Johansen

2010

European Diabetes Nursing

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Background: The importance of spousal support in type 2 diabetes mellitus (T2DM) patient management is often neglected. We prospectively investigated spouses' needs for T2DM information, and whether their perceptions of health changes in their diabetic partners correlated with changes in objective and subjective health parameters for the partners. Methods: Spouses and partners with T2DM (n=52 per group) were followed for two years. Questionnaires on T2DM information/education and general health perception of themselves and their partners were given to spouses at start and end of study. Perceived changes in partners' health were compared with changes in objective (10-year Framingham coronary heart disease risk) and subjective (health-related quality-of-life [EuroQoL]) measures. Results: Spouses' (mean age±SD 58±10 years, n=42 females) self-reported needs for T2DM information/education were high at both assessments (61.5%/76.7%; 46.2%/63.0%, respectively). General health of diabetic partners (mean age 60±8 years, n=42 males) was perceived as improved by 10%, worsened by 27% and unchanged by 63% of spouses. Significant correlations were observed between spouses who perceived improvements in partners' health, and subjective and objective parameters of partners' health (EuroQoL scores increased by 18; Framingham risk reduced by 2.0±3.0%); similar correlations were observed in spouses who perceived worsening of partners' health (EuroQoL scores decreased by 7±15; Framingham risk increased by 1.7±4.1%). Spouses' results showed moderate sensitivity for capturing health worsening in relation to increase in Framingham risk (57%); specificity in relation to no change or reduction in Framingham risk was high (74%). Conclusion: Spouses' needs for T2DM information/education were high. Perceived changes in partners' health significantly correlated with subjective and objective outcome data. Further studies should investigate whether spouses' perceptions of negative changes could be used to trigger more intensive T2DM management strategies.

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Section: Discussionmentioning

confidence: 98%

“…13,14 Inclusion/exclusion criteria and recruitment procedures for this trial have been described previously. 9,12 …”

Section: Study Flowmentioning

confidence: 99%

Section: Assessment Of Objective Measures Of Healthmentioning

confidence: 99%

See 1 more Smart Citation

Spouses’ educational needs and perceptions of health in partners with type 2 diabetes

Orvik

Ribu

Johansen

2010

European Diabetes Nursing

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“…Individuals included in the prospective trial were referred for voluntary stress echocardiography and invasive coronary angiography. Details of the design and results of the cross-sectional and prospective studies have been published [7,11]. All participants gave written informed consent and the studies were conducted in accordance with the Helsinki Declaration and approved by the Regional Ethics Committee and the Norwegian Data Inspectorate.…”

Section: Methodsmentioning

confidence: 99%

“…Thus, current understanding suggests that broad, multiple intervention strategies including lifestyle changes, aggressive blood pressure and lipid lowering, in addition to glucose control, are necessary for mitigating morbidity and mortality related to macrovascular disease [5,6]. Consistent with this concept, the prospective, randomized Asker and Bærum Cardiovascular Diabetes (ABCD) trial on 120 T2DM subjects found that structured care encompassing a comprehensive and intensive preventive strategy reduced the primary efficacy outcome of change in the estimated 10-year absolute risk for fatal coronary heart disease at 2 years compared to conventional care [7]. …”

Section: Introductionmentioning

confidence: 99%

Determinants and prognostic implications of Cardiac Troponin T measured by a sensitive assay in Type 2 Diabetes Mellitus

Hallén

Johansen

Birkeland

et al. 2010

Cardiovasc Diabetol

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BackgroundThe cardiac troponins are biomarkers used for diagnosis of myocardial injury. They are also powerful prognostic markers in many diseases and settings. Recently introduced high-sensitivity assays indicate that chronic cardiac troponin elevations are common in response to cardiovascular (CV) morbidity. Type 2 diabetes mellitus (T2DM) confers a high risk of CV disease, but little is known about chronic cardiac troponin elevations in diabetic subjects. Accordingly, we aimed to understand the prevalence, determinants, and prognostic implications of cardiac troponin T (cTnT) elevations measured with a high-sensitivity assay in patients with T2DM.MethodscTnT was measured in stored, frozen serum samples from 124 subjects enrolled in the Asker and Bærum Cardiovascular Diabetes trial at baseline and at 2-year follow-up, if availabe (96 samples available). Results were analyzed in relation to baseline variables, hospitalizations, and group assignment (multifactorial intensive versus conventional diabetes care for lowering CV risk).ResultsOne-hundred thirteen (90 %) had detectable cTnT at baseline and of those, 22 (18 % of the total population) subjects had values above the 99th percentile for healthy controls (13.5 ng/L). Levels at baseline were associated with conventional CV risk factors (age, renal function, gender). There was a strong correlation between cTnT levels at the two time-points (r = 0.92, p > 0.001). Risk for hospitalizations during follow-up increased step-wise by quartiles of hscTnT measured at baseline (p = 0.058).ConclusionsElevations of cTnT above the 99th percentile measured by a highly sensitive assay were encountered frequently in a population of T2DM patients. cTnT levels appeared to be stable over time and associated with conventional CV risk factors. Although a clear trend was present, no statistically robust associations with adverse outcomes could be found.

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Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus

Hemmingsen

Lund

Gluud

et al. 2011

Cochrane Database of Systematic Reviews

141

129

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Effects of structured hospital‐based care compared with standard care for Type 2 diabetes—The Asker and Baerum Cardiovascular Diabetes Study, a randomized trial

Abstract: This study shows that 2 years of structured care combining lifestyle and pharmacological interventions improved several CV risk factors and reduced the estimated 10-year absolute risk for CHD in patients with Type 2 diabetes.

Cited by 24 publications

References 37 publications

Spouses’ educational needs and perceptions of health in partners with type 2 diabetes

Spouses’ educational needs and perceptions of health in partners with type 2 diabetes

Determinants and prognostic implications of Cardiac Troponin T measured by a sensitive assay in Type 2 Diabetes Mellitus

Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus

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