title: Evaluation of a structured teaching and treatment programme for type 2 diabetes in general practice in a rural area of Austria.
abstract: The efficacy of a treatment and teaching programme for non-insulin-treated Type 2 diabetic patients in general practice was evaluated in a prospective, controlled study. In a rural area in southern Austria, 53 patients from seven general practices participated in a structured programme (intervention group) and 55 patients from seven general practices without the programme served as the control group. After 6 months the weight reduction in the intervention group was 2.6 kg (1.6-3.7 kg, p < 0.001) and the difference in HbA1c between the groups was 0.92% (0.23-1.61%, p < 0.01) at follow-up. Systolic (-16.6 mmHg) and diastolic (-11.1 mmHg) blood pressure, serum triglycerides (-0.63 mmol I-1), and serum cholesterol (-0.40 mmol I-1) were reduced significantly in the intervention group (p < 0.006). The number of patients with callus formation and poor nail care decreased significantly after participating in the teaching programme (p < 0.001). In the control group no reduction in body weight, metabolic control or in risk factors for diabetic foot complications were observed. Calculated health care costs per patient and year decreased in the intervention group (-33 pounds) and increased in the control group (+ 30 pounds) mainly due to changes in prescription of oral hypoglycaemic agents in both groups. This programme may be an efficient and helpful model to increase overall quality of diabetes care according to the St Vincent Declaration.
authors.affiliation: Department of Internal Medicine, Karl-Franzens-University, Graz, Austria.
authors.forename: T R
authors.initials: TR
authors.lastname: Pieber
authors.forename: A
authors.initials: A
authors.lastname: Holler
authors.forename: A
authors.initials: A
authors.lastname: Siebenhofer
authors.forename: G A
authors.initials: GA
authors.lastname: Brunner
authors.forename: B
authors.initials: B
authors.lastname: Semlitsch
authors.forename: S
authors.initials: S
authors.lastname: Schattenberg
authors.forename: H
authors.initials: H
authors.lastname: Zapotoczky
authors.forename: W
authors.initials: W
authors.lastname: Rainer
authors.forename: G J
authors.initials: GJ
authors.lastname: Krejs
mesh_terms: D001317:Austria; D001794:Blood Pressure; D001835:Body Weight; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy*; D005194:Family Practice; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012423:Rural Health; D012424:Rural Population; D012648:Self Care; D014280:Triglycerides / Q000097:blood
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin; D014280:Triglycerides