Effectiveness of a locality-based integrated diabetes care service on clinical outcomes.

Abstract:

AIMS:To evaluate the effectiveness of a new locality-based integrated diabetes care service for people with Type 2 diabetes in an inner regional area. METHODS:A quasi-experimental evaluation comparing baseline and follow up clinical data collected from general practices and specialist services participating in an integrated diabetes care programme in an inner-regional area. Patients had at least one specialist service consultation. The primary outcome was glycated haemoglobin (HbA1c). RESULTS:Clinical data were collected for 178/239 patients (74.5% participation; aged 65± 11(SD) years, 46% female; median [interquartile range (IQR)] diabetes duration 19 (11.0-24.0) years from seven general practices over 33 months (median 18.5 months). There were reductions in HbA1c -0.7±1.6 % (8±18 mmol/mol) (p<0.001), systolic blood pressure -5.8±19.5 mmHg (p<0.001), diastolic blood pressure -2.4±14.3 mmHg (p=0.04), total cholesterol -0.5±1.3 mmol/l (p<0.001), low-density lipoprotein (LDL) -0.4±0.9 mmol/l (p<0.001), Body Mass Index -0.5±1.6 kg/m2 (p<0.001), weight -1.8±4.7 kg (p<0.001). Urine albumin creatinine ratio [median (IQR)] at baseline was 3.0 mg/mmol (0.7-7) vs follow up 1.9 mg/mmol (0.8-5.5) p< 0.54). CONCLUSIONS:Glycaemia and cardiovascular risk factors can be reduced in patients with long-standing Type 2 diabetes by moving to a locality based integrated primary-secondary care diabetes care service. This article is protected by copyright. All rights reserved.

journal_name

Intern Med J

authors

Zarora R,MacMillan F,Piya MK,Fernandes B,Simmons D

doi

10.1111/imj.15211

subject

Has Abstract

pub_date

2021-01-20 00:00:00

eissn

1444-0903

issn

1445-5994

pub_type

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