title: Results of the pilot study of DIADEM: a comprehensive disease management programme for type 2 diabetes.
abstract: OBJECTIVE
  The purpose of the study was to evaluate the feasibility and preliminary clinical effects of the DIADEM disease management programme for type 2 diabetic patients.
  
  
  METHODS
  The study was performed at two test sites (Cardiff, UK: Aachen, Germany) including 137 and 166 patients, respectively. In 16 study centres any patients with type 2 diabetes capable of communicating by phone and able to perform blood pressure, blood glucose or urine glucose self-measurements were included. The maximum programme duration was 6 months at Cardiff and 4 months at Aachen, during which patients were assessed for glycaemic control, cardiovascular risk profile and the presence of complications of diabetes. Data were entered via the internet to a central server.
  
  
  RESULTS
  At entry into the programme the patient group in Cardiff had significantly lower mean age (60.3+/-9.4 years versus 64.9+/-8.7 years, p<0.001) and duration of diabetes (6.1+/-5.7 years versus 7.4+/-7.0 years, p<0.05) than in Aachen, however body mass index (31.6+/-5.2 kg/m(2) versus 29.5+/-4.9 kg/m(2), p<0.01), HbA1c (7.7+/-1.2% versus 7.1+/-1.2%, p<0.001) and systolic blood pressure (138.4+/-15.1 mmHg versus 133.5+/-11.5 mmHg, p<0.001) were significantly higher. In contrast, total cholesterol (4.7+/-1.0 mmol/l versus 5.5+/-1.1 mmol/l, p<0.001) was significantly lower in Cardiff compared to Aachen. Following entry into the programme highly significant improvements in HbA1c (Cardiff from 7.7% to 7.1%, p<0.001; Aachen from 7.2% to 6.8%, p<0.05) and total cholesterol concentrations (Cardiff: 4.66-4.46 mmol/l; Aachen: 5.33-5.15 mmol/l; both p<0.05) were observed. There were no significant changes in blood pressure at either site.
  
  
  CONCLUSIONS
  Intensive diabetes care was delivered to DIADEM patients and relevant and significant improvements in diabetes care were achieved demonstrating that an IT-based diabetes disease management service can improve care for patients with type 2 diabetes.
authors.affiliation: University of Wales College of Medicine, Cardiff, UK. luzio@cardiff.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Luzio
authors.forename: W
authors.initials: W
authors.lastname: Piehlmeier
authors.forename: C
authors.initials: C
authors.lastname: Tovar
authors.forename: S
authors.initials: S
authors.lastname: Eberl
authors.forename: G
authors.initials: G
authors.lastname: Lätzsch
authors.forename: E
authors.initials: E
authors.lastname: Fallböhmer
authors.forename: E
authors.initials: E
authors.lastname: Rumpel
authors.forename: D R
authors.initials: DR
authors.lastname: Owens
authors.forename: R
authors.initials: R
authors.lastname: Landgraf
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D019468:Disease Management; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010865:Pilot Projects; D012984:Software; D014852:Wales
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human