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


METHODS
Parallel clinical trial with randomisation at practice level.


METHODS
Fifteen general practices.


METHODS
Type 2 diabetic patients, aged < 76 years, treated by a GP.


METHODS
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.
Groeneveld
Y
Y
Department of General Practice, Leiden University Medical Centre, The Netherlands. y.groeneveld@lumc.nl
Petri
H
H
Hermans
J
J
Springer
M
M
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D005194:Family Practice / Q000592:standards*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care; D012944:Social Support
D001786:Blood Glucose; D006442:Glycated Hemoglobin