| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 2799066 | Diabetes Research and Clinical Practice | 2006 | 5 Pages |
Aims: To analyse the effects of a disease management programme on the vascular risk profile of Type 2 diabetic patients.Materials and methods: So far 4872 patients from 647 physicians (primary care physicians or internal specialists) have were enrolled into the programme. Participating physicians were provided with a handbook containing guideline-based recommendations with respect to (1) patient education, lifestyle changes and multifactorial intervention of the vascular risk factors, (2) early detection of secondary complications, and (3) management of high-risk patients (e.g. patients with diabetic nephropathy). The programme is characterized by regular visits of patients every 3 months with structured documentation of risk and intervention parameters. Data feedback and decision-support in form of Care Cards (using a rule-based system, SAS version 8.02) for both physician and patient is performed by a an evaluation centre located at a University Hospital Diabetes Centre. Analysis of 548 Type 2 diabetic patients participating for at least 24 months in the disease management programme (age 64.7 ± 10.0 years, 54% males, diabetes duration 7.5 ± 6.3 years, intervention period 39.0 ± 16.6 months). Test for statistical significance of intraindividual differences by Wilcoxon signed-rank test for paired samples.Results: At inclusion and after 39 months ( ): HbA1c 7.6 ± 1.5 (7.3 ± 1.4)%, p < 0.0001: RRsyst 147 ± 19 (140 ± 18) mm Hg, p < 0.0001; RRdiast 84 ± 10 (80 ± 10) mm Hg, p < 0.0001); total cholesterol 221 ± 46 (211 ± 44) mg/dl, p < 0.0001; triglycerides 208 ± 145 (183 ± 114) mg/dl, p < 0.001; normoalbuminuria 9% (23%); microalbuminuria 24% (18%); macroalbuminuria 2% (1%); impaired creatinine clearance < 90 ml/min (calculated by Cockcroft-Gault formula) 65% (58%); modifiable risk according to a risk score: 0–5 points (pt.): low risk: 17% (33%); 6–10 pt. 65% (59%); 11–15 pt.: high, risk: 18% (8%).Conclusion: In Type 2 diabetic patients participating for more than two years in a DMP with target-oriented treatment approach and regular data feedback highly significant improvements of the vascular risk profile can be observed.
