Improving diabetes processes of care in managed care.


OBJECTIVE:To evaluate the impact of systematic patient evaluation and patient and provider feedback on the processes and intermediate outcomes of diabetes care in Independent Practice Association model internal medicine practices. RESEARCH DESIGN AND METHODS:Nine practices providing care to managed care patients were randomly assigned as intervention or comparison sites. Intervention-site subjects had Annual Diabetes Assessment Program (ADAP) assessments (HbA(1c), blood pressure, lipids, smoking, retinal photos, urine microalbumin, and foot examination) at years 1 and 2. Comparison-site subjects had ADAP assessments at year 2. At Intervention sites, year 1 ADAP results were reviewed with subjects, mailed to providers, and incorporated into electronic medical records with guideline-generated suggestions for treatment and follow-up. Medical records were evaluated for both groups for the year before both the year 1 and year 2 ADAP assessments. Processes and intermediate outcomes were compared using linear and logistic mixed hierarchical models. RESULTS:Of 284 eligible subjects, 103 of 173 (60%) at the Intervention sites and 71 of 111 (64%) at the comparison sites participated; 83 of 103 (81%) of the intervention-site subjects returned for follow-up at year 2. Performance of the six recommended assessments improved in intervention-site subjects at year 2 compared with year 1 (5.8 vs. 4.3, P = 0.0001) and compared with comparison-site subjects at year 2 (4.2, P = 0.014). No significant changes were noted in intermediate outcomes. CONCLUSIONS:The ADAP significantly improved processes of care but not intermediate outcomes. Additional interventions are needed to improve intermediate outcomes.


Diabetes Care


Diabetes care


Ilag LL,Martin CL,Tabaei BP,Isaman DJ,Burke R,Greene DA,Herman WH




Has Abstract


2003-10-01 00:00:00












  • Frailty and Risk of Fractures in Patients With Type 2 Diabetes.

    abstract:OBJECTIVE:We aimed to explore whether frailty was associated with fracture risk and whether frailty could modify the propensity of type 2 diabetes toward increased risk of fractures. RESEARCH DESIGN AND METHODS:Data were from a prospective cohort study. Our primary outcome was time to the first incident clinical fragi...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Li G,Prior JC,Leslie WD,Thabane L,Papaioannou A,Josse RG,Kaiser SM,Kovacs CS,Anastassiades T,Towheed T,Davison KS,Levine M,Goltzman D,Adachi JD,CaMos Research Group.

    更新日期:2019-04-01 00:00:00

  • Elevated ambulatory blood pressure in microalbuminuric IDDM patients is inversely associated with renal plasma flow. A compensatory mechanism?

    abstract:OBJECTIVE:To evaluate the relationship between renal function, ambulatory blood pressure (AMBP), and glycemic control in microalbuminuric IDDM patients compared with normoalbuminuric patients. RESEARCH DESIGN AND METHODS:Nineteen male patients (age 33 +/- 6 years) with slight microalbuminuria (UAE 20-70 micrograms/min...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Poulsen PL,Juhl B,Ebbehøj E,Klein F,Christiansen C,Mogensen CE

    更新日期:1997-03-01 00:00:00

  • Deviation from developmentally appropriate self-care autonomy. Association with diabetes outcomes.

    abstract:OBJECTIVE:Treatment of IDDM in youth emphasized balancing children's self-care autonomy with their psychological maturity. However, few data exist to guide clinicians or parents, and little is known about correlates of deviations from this ideal. RESEARCH DESIGN AND METHODS:In this cross-sectional study, IDDM self-car...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Wysocki T,Taylor A,Hough BS,Linscheid TR,Yeates KO,Naglieri JA

    更新日期:1996-02-01 00:00:00

  • Plasma adiponectin plays an important role in improving insulin resistance with glimepiride in elderly type 2 diabetic subjects.

    abstract:OBJECTIVE:We investigated the effect of glimepiride, a third-generation sulfonylurea hypoglycemic agent, on insulin resistance in elderly patients with type 2 diabetes, in connection with plasma adiponectin and 8-epi-prostagrandin F2alpha (8-epi-PGF2alpha), an oxidative stress marker. RESEARCH DESIGN AND METHODS:A tot...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Tsunekawa T,Hayashi T,Suzuki Y,Matsui-Hirai H,Kano H,Fukatsu A,Nomura N,Miyazaki A,Iguchi A

    更新日期:2003-02-01 00:00:00

  • Acute alcohol consumption improves insulin action without affecting insulin secretion in type 2 diabetic subjects.

    abstract:OBJECTIVE:Long-term exposure to alcohol is associated with an improvement in insulin sensitivity. At this time, however, there is no definitive proof that alcohol per se has an effect on the insulin sensitivity index (S(i)) in type 2 diabetes patients. The aim of the present study was to assess the role of acute modera...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Avogaro A,Watanabe RM,Dall'Arche A,De Kreutzenberg SV,Tiengo A,Pacini G

    更新日期:2004-06-01 00:00:00

  • Provider-patient communication and metabolic control.

    abstract:OBJECTIVE:To determine whether nurses' and NIDDM patients' communication styles during consultations are related to subsequent metabolic control and to examine factors influencing patterns of communication in these consultations. RESEARCH DESIGN AND METHODS:A total of 47 NIDDM patients participated in the study and co...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Street RL Jr,Piziak VK,Carpentier WS,Herzog J,Hejl J,Skinner G,McLellan L

    更新日期:1993-05-01 00:00:00

  • Diabetes, glycemic control, and new-onset heart failure in patients with stable coronary artery disease: data from the heart and soul study.

    abstract:OBJECTIVE:Diabetes is a predictor of both coronary artery disease (CAD) and heart failure. It is unknown to what extent the association between diabetes and heart failure is influenced by other risk factors for heart failure. RESEARCH DESIGN AND METHODS:We evaluated the association of diabetes and A1C with incident he...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: van Melle JP,Bot M,de Jonge P,de Boer RA,van Veldhuisen DJ,Whooley MA

    更新日期:2010-09-01 00:00:00

  • Intra-individual variability of the metabolic effect of inhaled insulin together with an absorption enhancer.

    abstract:OBJECTIVE:To study the metabolic effect and the variability of the effect elicited by inhalation of 87.2 U insulin powder combined with an absorption enhancer. The metabolic effect was compared with that of 10.2 U regular insulin injected subcutaneously and of 5.5 U regular insulin given intravenously RESEARCH DESIGN ...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Heinemann L,Klappoth W,Rave K,Hompesch B,Linkeschowa R,Heise T

    更新日期:2000-09-01 00:00:00

  • The effect of oral antidiabetic agents on A1C levels: a systematic review and meta-analysis.

    abstract:OBJECTIVE:Previous reviews of the effect of oral antidiabetic (OAD) agents on A1C levels summarized studies with varying designs and methodological approaches. Using predetermined methodological criteria, we evaluated the effect of OAD agents on A1C levels. RESEARCH DESIGN AND METHODS:The Excerpta Medica (EMBASE), the...

    journal_title:Diabetes care

    pub_type: 杂志文章,meta分析,评审


    authors: Sherifali D,Nerenberg K,Pullenayegum E,Cheng JE,Gerstein HC

    更新日期:2010-08-01 00:00:00

  • Diabetes nutrition and complications trial (DNCT): food intake and targets of diabetes treatment in a sample of Spanish people with diabetes. Diabetes and Nutrition Study Group of the Spanish Diabetes Association (GSEDNu).

    abstract:OBJECTIVE:To know the nutritional pattern of people with diabetes in Spain and that pattern's relationship with targets of metabolic control. RESEARCH DESIGN AND METHODS:The Diabetes Nutrition and Complications Trial (DNCT) is a prospective multicenter study designed to determine the nutritional behavior of diabetic p...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究



    更新日期:1997-07-01 00:00:00

  • Cost-effectiveness of aspirin use among persons with newly diagnosed type 2 diabetes.

    abstract:OBJECTIVE:To assess the long-term cost-effectiveness of aspirin use among adults aged >or=40 years with newly diagnosed type 2 diabetes. RESEARCH DESIGN AND METHODS:We used a validated cost-effectiveness model of type 2 diabetes to assess the lifetime health and cost consequences of use or nonuse of aspirin. The model...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Li R,Zhang P,Barker LE,Hoerger TJ

    更新日期:2010-06-01 00:00:00

  • Effect of longitudinal changes in visceral fat area and other anthropometric indices to the changes in metabolic risk factors in Japanese men: the Hitachi Health Study.

    abstract:OBJECTIVE:The effects of longitudinal changes in the visceral fat area (VFA), and other anthropometric indices, on the risk factors of metabolic syndrome were not studied. We calculated the changes in metabolic risk factors in relation to changes in certain anthropometric indices in a large-scale study of Japanese men....

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Matsushita Y,Nakagawa T,Yamamoto S,Takahashi Y,Yokoyama T,Mizoue T,Noda M

    更新日期:2012-05-01 00:00:00

  • Alcohol and the NIDDM patient.

    abstract::Historically, alcohol use by the diabetic patient has been controversial. Recent studies in the general population have shown an improvement in mortality with moderate alcohol intake (one to three drinks per day). This improved mortality is greatest in those individuals who have a higher risk of ischemic heart disease...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审


    authors: Bell DS

    更新日期:1996-05-01 00:00:00

  • Treatment of recent-onset type 1 diabetic patients with DiaPep277: results of a double-blind, placebo-controlled, randomized phase 3 trial.

    abstract:OBJECTIVE:To evaluate safety and efficacy of DiaPep277 in preserving β-cell function in type 1 diabetic patients. RESEARCH DESIGN AND METHODS:DIA-AID 1 is a multinational, phase 3, balanced-randomized, double-blind, placebo-controlled, parallel-group clinical study. Newly diagnosed patients (N = 457, aged 16-45 years)...

    journal_title:Diabetes care

    pub_type: 杂志文章,收录出版


    authors: Raz I,Ziegler AG,Linn T,Schernthaner G,Bonnici F,Distiller LA,Giordano C,Giorgino F,de Vries L,Mauricio D,Procházka V,Wainstein J,Elias D,Avron A,Tamir M,Eren R,Peled D,Dagan S,Cohen IR,Pozzilli P,DIA-AID 1 Writin

    更新日期:2014-01-01 00:00:00

  • Ketoacidosis at diabetes onset is still frequent in children and adolescents: a multicenter analysis of 14,664 patients from 106 institutions.

    abstract:OBJECTIVE:We aimed at analyzing the frequency, clinical characteristics, and trends associated with the occurrence of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes on the basis of long-term follow-up data. RESEARCH DESIGN AND METHODS:A total of 106 pediatric diabetes centers in Germany and Austria partic...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Neu A,Hofer SE,Karges B,Oeverink R,Rosenbauer J,Holl RW,DPV Initiative and the German BMBF Competency Network for Diabetes Mellitus.

    更新日期:2009-09-01 00:00:00

  • Differential associations of oral glucose tolerance test-derived measures of insulin sensitivity and pancreatic β-cell function with coronary artery calcification and microalbuminuria in type 2 diabetes.

    abstract::OBJECTIVE We evaluated relationships of oral glucose tolerance testing (OGTT)-derived measures of insulin sensitivity and pancreatic β-cell function with indices of diabetes complications in a cross-sectional study of patients with type 2 diabetes who are free of overt cardiovascular or renal disease. RESEARCH DESIGN ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Mulvey CK,McNeill AM,Girman CJ,Churchill TW,Terembula K,Ferguson JF,Shah R,Mehta NN,Qasim AN,Rickels MR,Reilly MP

    更新日期:2014-01-01 00:00:00

  • Role of adiposity and lifestyle in the relationship between family history of diabetes and 20-year incidence of type 2 diabetes in U.S. women.

    abstract:OBJECTIVE:To evaluate to what extent the association between family history of diabetes and risk of type 2 diabetes can be explained by excess adiposity and lifestyle risk factors. RESEARCH DESIGN AND METHODS:We analyzed data from 73,227 women who participated in the Nurses' Health Study cohort. A family history of di...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: van 't Riet E,Dekker JM,Sun Q,Nijpels G,Hu FB,van Dam RM

    更新日期:2010-04-01 00:00:00

  • Randomized trial of behavioral family systems therapy for diabetes: maintenance of effects on diabetes outcomes in adolescents.

    abstract:OBJECTIVE:Studies showing that family communication and conflict resolution are critical to effective management of type 1 diabetes in adolescents have stimulated interest in evaluating psychological treatments targeting these processes. Previous trials have shown that Behavioral Family Systems Therapy (BFST) improved ...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验


    authors: Wysocki T,Harris MA,Buckloh LM,Mertlich D,Lochrie AS,Mauras N,White NH

    更新日期:2007-03-01 00:00:00

  • Exogenous estrogen exposures and changes in diabetic retinopathy. The Wisconsin Epidemiologic Study of Diabetic Retinopathy.

    abstract:OBJECTIVE:To investigate whether the use of exogenous estrogen is associated with changes in the severity of diabetic retinopathy and the incidence of macular edema. RESEARCH DESIGN AND METHODS:The study design involved observation of two well-defined cohorts of women with diabetes. One group was diagnosed with diabet...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Klein BE,Klein R,Moss SE

    更新日期:1999-12-01 00:00:00

  • A meta-analysis of the association between childhood type 1 diabetes and atopic disease.

    abstract:OBJECTIVE:To review the published literature and perform a meta-analysis summarizing the evidence in support of an inverse association between type 1 diabetes and the atopic disorders: asthma, eczema, and allergic rhinitis in children. RESEARCH DESIGN AND METHODS:MEDLINE, Web of Science, and PubMed were searched to id...

    journal_title:Diabetes care

    pub_type: 杂志文章,meta分析


    authors: Cardwell CR,Shields MD,Carson DJ,Patterson CC

    更新日期:2003-09-01 00:00:00

  • Using Indirect Measures to Identify Geographic Hot Spots of Poor Glycemic Control: Cross-sectional Comparisons With an A1C Registry.

    abstract:OBJECTIVE:Focusing health interventions in places with suboptimal glycemic control can help direct resources to neighborhoods with poor diabetes-related outcomes, but finding these areas can be difficult. Our objective was to use indirect measures versus a gold standard, population-based A1C registry to identify areas ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Lee DC,Jiang Q,Tabaei BP,Elbel B,Koziatek CA,Konty KJ,Wu WY

    更新日期:2018-07-01 00:00:00

  • Sodium-Glucose Cotransporter Inhibitors: Effects on Renal and Intestinal Glucose Transport: From Bench to Bedside.

    abstract::Type 2 diabetes is a chronic disease with disabling micro- and macrovascular complications that lead to excessive morbidity and premature mortality. It affects hundreds of millions of people and imposes an undue economic burden on populations across the world. Although insulin resistance and insulin secretory defects ...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审


    authors: Mudaliar S,Polidori D,Zambrowicz B,Henry RR

    更新日期:2015-12-01 00:00:00

  • Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S.

    abstract:OBJECTIVE:To project the number of people with diagnosed diabetes in the U.S. through 2050, accounting for changing demography and diabetes prevalence rates. RESEARCH DESIGN AND METHODS:We combined age-, sex-, and race-specific diagnosed diabetes prevalence rates-predicted from 1980-1998 trends in prevalence data from...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Boyle JP,Honeycutt AA,Narayan KM,Hoerger TJ,Geiss LS,Chen H,Thompson TJ

    更新日期:2001-11-01 00:00:00

  • Metabolic control and progression of retinopathy. The Diabetes in Early Pregnancy Study. National Institute of Child Health and Human Development Diabetes in Early Pregnancy Study.

    abstract:OBJECTIVE:To evaluate the role of metabolic control in the progression of diabetic retinopathy during pregnancy. RESEARCH DESIGN AND METHODS:We conducted a prospective cohort study of 155 diabetic women in the Diabetes in Early Pregnancy Study followed from the periconceptional period to 1 month postpartum. Fundus pho...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究


    authors: Chew EY,Mills JL,Metzger BE,Remaley NA,Jovanovic-Peterson L,Knopp RH,Conley M,Rand L,Simpson JL,Holmes LB

    更新日期:1995-05-01 00:00:00

  • Effects of Liraglutide on Heart Rate and Heart Rate Variability: A Randomized, Double-Blind, Placebo-Controlled Crossover Study.

    abstract:OBJECTIVE:Reduced heart rate variability (HRV) and increased heart rate (HR) have been associated with cardiovascular mortality. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) increase HR, and studies have suggested that they may reduce HRV. We examined the effect of the GLP-1 RA liraglutide on HRV and diurnal v...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验


    authors: Kumarathurai P,Anholm C,Larsen BS,Olsen RH,Madsbad S,Kristiansen O,Nielsen OW,Haugaard SB,Sajadieh A

    更新日期:2017-01-01 00:00:00

  • Serum xylosyltransferase activity in diabetic patients as a possible marker of reduced proteoglycan biosynthesis.

    abstract:OBJECTIVE:Proteoglycan metabolism is altered in diabetic patients. The xylosyltransferases (XTs) are the initial and rate-limiting enzymes in the biosynthesis of the glycosaminoglycan chains in proteoglycans. Here, we analyzed whether the changed proteoglycan metabolism leads to altered serum XT levels in diabetic pati...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Götting C,Kuhn J,Kleesiek K

    更新日期:2008-10-01 00:00:00

  • Determinants for the effectiveness of lifestyle intervention in the Finnish Diabetes Prevention Study.

    abstract:OBJECTIVE:Intensive lifestyle intervention significantly reduced diabetes incidence among the participants in the Finnish Diabetes Prevention Study. We investigated whether and to what extent risk factors for type 2 diabetes and other baseline characteristics of the study participants modified the effectiveness of the ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Lindström J,Peltonen M,Eriksson JG,Aunola S,Hämäläinen H,Ilanne-Parikka P,Keinänen-Kiukaanniemi S,Uusitupa M,Tuomilehto J,Finnish Diabetes Prevention Study (DPS) Group.

    更新日期:2008-05-01 00:00:00

  • Glimepiride versus metformin as monotherapy in pediatric patients with type 2 diabetes: a randomized, single-blind comparative study.

    abstract:OBJECTIVE:To compare the efficacy and safety of glimepiride versus metformin in pediatric subjects with type 2 diabetes inadequately controlled with diet and exercise alone or oral monotherapy. RESEARCH DESIGN AND METHODS:This 26-week, single-blind, active-controlled, multinational study randomized 285 subjects to rec...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Gottschalk M,Danne T,Vlajnic A,Cara JF

    更新日期:2007-04-01 00:00:00

  • Ambient Air Pollutants Have Adverse Effects on Insulin and Glucose Homeostasis in Mexican Americans.

    abstract:OBJECTIVE:Recent studies suggest that air pollution plays a role in type 2 diabetes (T2D) incidence and mortality. The underlying physiological mechanisms have yet to be established. We hypothesized that air pollution adversely affects insulin sensitivity and secretion and serum lipid levels. RESEARCH DESIGN AND METHO...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Chen Z,Salam MT,Toledo-Corral C,Watanabe RM,Xiang AH,Buchanan TA,Habre R,Bastain TM,Lurmann F,Wilson JP,Trigo E,Gilliland FD

    更新日期:2016-04-01 00:00:00

  • Impact of Type 2 Diabetes and Postmenopausal Hormone Therapy on Incidence of Cognitive Impairment in Older Women.

    abstract:OBJECTIVE:In older women, higher levels of estrogen may exacerbate the increased risk for cognitive impairment conveyed by diabetes. We examined whether the effect of postmenopausal hormone therapy (HT) on cognitive impairment incidence differs depending on type 2 diabetes. RESEARCH DESIGN AND METHODS:The Women's Heal...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验


    authors: Espeland MA,Brinton RD,Hugenschmidt C,Manson JE,Craft S,Yaffe K,Weitlauf J,Vaughan L,Johnson KC,Padula CB,Jackson RD,Resnick SM,WHIMS Study Group.

    更新日期:2015-12-01 00:00:00