title: Initiative for a new diabetes therapeutic approach in a Mediterranean country: the INDEED study.
abstract: OBJECTIVE
  To assess the efficacy of a strategy to improve vascular risk management in patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  This was a pilot best practice implementation enhancement programme that enrolled 578 patients with T2DM. A baseline visit was followed by a concerted effort from previously trained physicians to improve adherence to lifestyle advice and optimise drug treatment for all vascular risk factors. The patients were followed-up for 6 months. The UKPDS risk engine was used to estimate vascular risk in patients without established coronary heart disease (CHD) (n = 279).
  
  
  RESULTS
  There was an improvement in compliance to lifestyle measures and increased prescription of evidence-based medication. In patients without established CHD there was a 37% reduction in estimated risk for CHD, 44% for fatal CHD, 10% for stroke and 25% for fatal stroke (p < or = 0.003 for all comparisons vs. baseline). There was also a substantial increase in the proportion of patients with established CHD who achieved their vascular risk factor targets.
  
  
  CONCLUSIONS
  This is the first study to increase the adherence to multiple interventions in patients with T2DM in both primary care and hospital settings. Education of physicians and patients, distribution of guidelines/brochures, and the completion of a one-page form, motivated both physicians and patients to achieve multiple vascular risk factor goals.
authors: Atherosclerosis and Metabolic Syndrome Units, 2nd Propedeutic Department of Internal Medicine, Aristotelian University, Hippocration Hospital, Thessaloniki, Greece.
authors: V G
authors: VG
authors: Athyros
authors: A
authors: A
authors: Hatzitolios
authors: A
authors: A
authors: Karagiannis
authors: T P
authors: TP
authors: Didangelos
authors: F
authors: F
authors: Iliadis
authors: S
authors: S
authors: Dolgyras
authors: T
authors: T
authors: Vosnakidis
authors: P
authors: P
authors: Vasiliadis
authors: I
authors: I
authors: Malias
authors: K
authors: K
authors: Tziomalos
authors: M
authors: M
authors: Samouilidou
authors: D P
authors: DP
authors: Mikhailidis
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D004059:Diffusion of Innovation; D005260:Female; D006115:Greece; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D010865:Pilot Projects; D011446:Prospective Studies; D040242:Risk Reduction Behavior