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

Scand J Prim Health Care. 2001 Mar;19(1):25-30. doi: 10.1080/028134301300034585.

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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / psychology
  • Diabetes Mellitus, Type 2 / therapy*
  • Family Practice / standards*
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Outcome Assessment, Health Care*
  • Quality of Health Care
  • Social Support*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A