title: Individualised treatment goals in diabetes care.
abstract: OBJECTIVE
  To examine 1) patients' characteristics according to the treatment goal chosen at diabetes diagnosis, and 2) the association between individualised goals for glycated haemoglobin (HbA1c), blood pressure (BP) and lipids, and the risk factor level subsequently achieved.
  
  
  METHODS
  Follow-up study embedded in a multifaceted intervention study directed at doctors encouraging individualised goal-setting in newly diagnosed diabetic patients aged > or = 40 years.
  
  
  METHODS
  General practice.
  
  
  METHODS
  In all, 243 general practitioners and 674 patients participated.
  
  
  METHODS
  Risk factors for diabetic complications.
  
  
  RESULTS
  Relatively young age, low diagnostic plasma glucose, low BMI, a moderate or high level of physical activity and normoalbuminuria were associated with a treatment goal of good control at diagnosis. After 5 years, median HbA1c was 8.2%, 8.6% and 8.0% in patients with a goal of good, acceptable and poor control, respectively. Patients with a goal of good control versus those with a goal of acceptable control had a lower HbA1c level in a regression analysis adjusted for age, sex, HbA1c at diagnosis, BMI, total cholesterol, fasting triglycerides, BP, physical activity, smoking status and diabetes duration. We found no association between goals and the level of BP and lipids.
  
  
  CONCLUSIONS
  Doctors tend to pursue normoglycaemia in relatively young patients with low blood glucose, low BMI, high activity level and normoalbuminuria. Patients for whom a goal of normoglycaemia was chosen at diagnosis achieved favourable glycaemic control at 5-year follow-up. Whether doctors choosing the goals were good at predicting future glycaemic control, or whether goal-setting is an important motivational factor in achieving optimal glycaemic control needs to be explored.
authors.affiliation: Central Research Unit and Department of General Practice, University of Copenhagen, Copenhagen, Denmark. L.Hansen@gpract.ku.dk
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Hansen
authors.forename: Niels de Fine
authors.initials: Nde F
authors.lastname: Olivarius
authors.forename: Volkert
authors.initials: V
authors.lastname: Siersma
authors.forename: Thomas
authors.initials: T
authors.lastname: Drivsholm
authors.forename: John Sahl
authors.initials: JS
authors.lastname: Andersen
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D003718:Denmark; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids