Abstract:
OBJECTIVE:To compare clinical outcomes obtained using treatment algorithms versus standard "usual care" to treat patients with type 2 diabetes in a community setting. RESEARCH DESIGN AND METHODS:An observational group comparison was implemented in three community-based clinics in San Antonio, Texas: 1). a community clinic following treatment algorithms (CC-TA), 2). university clinic following treatment algorithms (UC-TA), and 3). a community clinic following standard "usual care" practices (CC-SC). Three hundred fifty-eight recently diagnosed type 2 diabetic patients (90% Mexican American, from low-income neighborhoods) who were consecutively identified at the three clinics were recruited. Following medical and laboratory evaluation, participants were started on treatment for hyperglycemia, hypertension, and dyslipidemia and followed for 12 months. RESULTS:Decrements in HbA(1c) at 12 months in the CC-TA and UC-TA were 3.1 and 3.3%, respectively, compared to 1.3% in the CC-SC (P < 0.0001). Corresponding decrements in fasting plasma glucose at 12 months were 94 and 99 mg/dl, respectively, versus 38 mg/dl in CC-SC (P < 0.0001). Reductions in total cholesterol, LDL cholesterol, and triglycerides at 12 months were greater in both algorithm-managed clinics compared to standard care-managed clinics (P < 0.0001). In algorithm-managed clinics, there were 30% more documented eye exams and 24% more documented foot exams than in standard care-managed patients. CONCLUSIONS:Adherence to the treatment algorithms improved metabolic outcomes in type 2 diabetic patients to a greater extent than standard care practices. These results have important clinical implications for the treatment of type 2 diabetic patients.
journal_name
Diabetes Carejournal_title
Diabetes careauthors
Fanning EL,Selwyn BJ,Larme AC,DeFronzo RAdoi
10.2337/diacare.27.7.1638subject
Has Abstractpub_date
2004-07-01 00:00:00pages
1638-46issue
7eissn
0149-5992issn
1935-5548pii
27/7/1638journal_volume
27pub_type
杂志文章,多中心研究相关文献
DIABETES CARE文献大全abstract:OBJECTIVE:Moderate alcohol consumption is associated with reduced incidence of type 2 diabetes and cardiovascular mortality and increases adiponectin concentrations, but effects might differ according to sex and beverage consumed. RESEARCH DESIGN AND METHODS:A total of 72 healthy individuals (22-56 years) were enrolle...
journal_title:Diabetes care
pub_type: 杂志文章,随机对照试验
doi:10.2337/dc08-1723
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:Plasma leptin, an important signal for the regulation of energy stores, is known to be influenced by many hormonal factors, but may also be affected by behavioral and environmental factors. The purpose of this study was to investigate the impact of lifestyle (diet composition, level of physical activity) on p...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.22.3.413
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:To describe the relative contributions of neurological and vascular abnormalities to the overall risk of diabetic foot ulceration. RESEARCH DESIGN AND METHODS:A case-control study of diabetic veterans from the Seattle Veterans Affairs Medical Center was conducted using data collected from 46 patients with di...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.18.2.216
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:Despite good evidence and clinical practice guidelines, studies document that treatment of type 2 diabetes is less than optimal. Lack of resources or limited access may put patients in rural communities at particular risk for suboptimal care. RESEARCH DESIGN AND METHODS:We conducted a prospective, before/aft...
journal_title:Diabetes care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2337/diacare.26.11.3061
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:In patients with clinical hemochromatosis, the frequency of diabetes ranges from 20 to 50%, and the heterozygosity for the C282Y mutation in the HFE gene might be associated with an increased risk for diabetes. There are also some reports that suggest that iron overload might cause diabetic nephropathy. RESE...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.24.7.1187
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:To estimate the cost-effectiveness of surgically induced weight loss relative to conventional therapy for the management of recently diagnosed type 2 diabetes in class I/II obese patients. RESEARCH DESIGN AND METHODS:This study builds on a within-trial cost-efficacy analysis. The analysis compares the lifeti...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc08-1749
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To examine the association of stage of change with diet and exercise behaviors in response to a lifestyle intervention for Native Hawaiians (NHs). RESEARCH DESIGN AND METHODS:A family ('ohana) support lifestyle intervention was compared with a standard intervention in NHs with or at risk for diabetes in two ...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.24.10.1770
更新日期:2001-10-01 00:00:00
abstract::Because recent knowledge indicates that the distribution of fat deposits in men may be a better predictor of cardiovascular disease than the degree of obesity alone, some risk factors for atherosclerosis were evaluated in 51 middle-aged men with non-insulin-dependent diabetes mellitus. Abdominal adiposity (waist/hip r...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.11.2.103
更新日期:1988-02-01 00:00:00
abstract:OBJECTIVE:The present study was designed to assess the effect of magnesium plus zinc, vitamins C plus E, and a combination of these micronutrients on nephropathy indexes in type 2 diabetic patients. RESEARCH DESIGN AND METHODS:In a randomized, double-blind, placebo-controlled clinical trial, 69 type 2 diabetic patient...
journal_title:Diabetes care
pub_type: 杂志文章,随机对照试验
doi:10.2337/diacare.28.10.2458
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To compare the duration of healing of foot ulcers with osteomyelitis in diabetic patients treated by medical treatment versus medical treatment associated with conservative orthopedic surgery. RESEARCH DESIGN AND METHODS:We entered into the study 67 diabetic patients who had a foot ulcer with osteomyelitis w...
journal_title:Diabetes care
pub_type: 临床试验,杂志文章
doi:10.2337/diacare.19.11.1257
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:Both food insecurity (limited food access owing to cost) and living in areas with low physical access to nutritious foods are public health concerns, but their relative contribution to diabetes management is poorly understood. RESEARCH DESIGN AND METHODS:This was a prospective cohort study. A random sample o...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc17-1981
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To determine the impact of changes to treatment on the incidence of severe hypoglycemia and its risk factors in a large population-based cohort of children with type 1 diabetes. RESEARCH DESIGN AND METHODS:The cohort consisted of 1,335 children (age at entry 9.5 +/- 4.3 years [mean +/- SD], range 0-18), yiel...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.27.10.2293
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:To examine β-cell function across a spectrum of glycemia among Asian Indians, a population experiencing type 2 diabetes development at young ages despite low BMI. RESEARCH DESIGN AND METHODS:One-thousand two-hundred sixty-four individuals without known diabetes in the Diabetes Community Lifestyle Improvement...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc12-2290
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To explore the nature of functional impairment in older people with diabetes. RESEARCH DESIGN AND METHODS:A population-based case-control study with detailed assessment of diabetes and functional status was undertaken. RESULTS:Altogether, 403 case subjects and 403 matched control subjects were studied (medi...
journal_title:Diabetes care
pub_type: 杂志文章,多中心研究
doi:10.2337/dc07-1784
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To investigate the association of metabolic and lifestyle factors with possible diabetic polyneuropathy (DPN) and neuropathic pain in patients with early type 2 diabetes. RESEARCH DESIGN AND METHODS:We thoroughly characterized 6,726 patients with recently diagnosed diabetes. After a median of 2.8 years, we s...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc19-2277
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:To prospectively examine the effect of weight loss 1 year after laparoscopic adjustable gastric band surgery on a broad range of health outcomes in 50 diabetic subjects. RESEARCH DESIGN AND METHODS:A total of 50 (17 men, 33 women) of 51 patients with type 2 diabetes, from a total of 500 consecutive patients,...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.25.2.358
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and safety of taspoglutide (R1583/BIM51077), a human once-weekly glucagon-like peptide-1 analog, in patients with type 2 diabetes inadequately controlled with metformin. RESEARCH DESIGN AND METHODS:Type 2 diabetic (n = 306) patients who failed to obtain glycemic control (A1C 7-9.5%) ...
journal_title:Diabetes care
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.2337/dc08-1961
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:Major depressive disorder (MDD) and type 2 diabetes have independent adverse effects on sexual functioning (SF). Bupropion (BU) reportedly has few sexual side effects, but its use in diabetes has not been studied. RESEARCH DESIGN AND METHODS:This article reports a planned secondary analysis of SF in 90 patie...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc10-1714
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To test the psychometric properties of the short form of the Chinese version Diabetes Quality of Life for Youth scale (C-DQOLY-SF). RESEARCH DESIGN AND METHODS:A 30-item C-DQOLY-SF was administered to 371 adolescents with type 1 diabetes. Exploratory and confirmatory factor analysis, correlation with HbA(1c)...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc11-0705
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To compare recent U.S. and U.K. guidelines on gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS:The guidelines from the American Diabetes Association, the American College of Obstetricians and Gynecologists, and the National Institute for Health and Clinical Excellence (NICE) in the U.K. were ...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc09-1376
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:The impact of major affective disorders on the effectiveness of diabetes prevention programs at promoting health behaviors has not been established. We investigated whether depression modifies the effectiveness of two pragmatic diabetes prevention programs at promoting increased physical activity. RESEARCH D...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc19-0400
更新日期:2019-10-01 00:00:00
abstract::Serum free insulin concentrations were measured in diabetic subjects given insulin intravenously by a glucose-controlled insulin infusion system ("closed-loop" artificial beta-cell) in two experimental situations: hourly during the day while given their usual diet and at short intervals after administration of a stand...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.3.2.274
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:Early use of insulin after diagnosis of type 2 diabetes is met with resistance because of associated weight gain, hypoglycemia, and fear of decreased compliance and quality of life (QoL). RESEARCH DESIGN AND METHODS:In treatment-naive patients with newly diagnosed type 2 diabetes, insulin and metformin were ...
journal_title:Diabetes care
pub_type: 杂志文章,随机对照试验
doi:10.2337/dc09-0653
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:Ruboxistaurin selectively inhibits protein kinase C-beta and ameliorates kidney disease in animal models of diabetes. The purpose of this study was to evaluate the effects of ruboxistaurin on diabetic nephropathy in humans. RESEARCH DESIGN AND METHODS:A randomized, double-blind, placebo-controlled, multicent...
journal_title:Diabetes care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.2337/diacare.28.11.2686
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:The cholesteryl ester transfer protein (CETP) plays a key role in the remodeling of triglyceride (TG)-rich and HDL particles. Sequence variations in the CETP gene may interfere with the effect of lipid-lowering treatment in type 2 diabetes. RESEARCH DESIGN AND METHODS:We performed a 30-week randomized double...
journal_title:Diabetes care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.2337/diacare.26.4.1216
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the prevalence of diabetes in pregnancy (gestational diabetes mellitus [GDM] and NIDDM) and to identify risk factors in the development of GDM in a native population in northwestern Ontario, Canada. RESEARCH DESIGN AND METHODS:A retrospective analysis of 1,305 singl...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.20.9.1422
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:Recent data suggest that residential environment may influence health behaviors and outcomes. We assessed whether perception of neighborhood problems was associated with diabetes behaviors and outcomes. RESEARCH DESIGN AND METHODS:This cross-sectional analysis included 7,830 diabetic adults enrolled in Trans...
journal_title:Diabetes care
pub_type: 杂志文章,多中心研究
doi:10.2337/dc07-1111
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether overweight and obese individuals with type 2 diabetes have higher basal and 24-h energy expenditure compared with healthy control subjects before and after adjustment for body composition, spontaneous physical activity (SPA), sex, and age. RESEARCH DESIGN AND ME...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.27.10.2416
更新日期:2004-10-01 00:00:00
abstract::Nine healthy volunteers with normal body weights were injected subcutaneously with 125I-labeled soluble human insulin (10 U) in one thigh and 133Xe in the contralateral thigh for the measurement of subcutaneous blood flow on 2 consecutive mornings. On one of the days, standardized massage of both injection sites was p...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.9.6.570
更新日期:1986-11-01 00:00:00
abstract:OBJECTIVE:This study estimated the screening prevalence of prediabetes and diabetes using a lower BMI cutoff of 23 kg/m(2) in Asians in the U.S. using the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2012. RESEARCH DESIGN AND METHODS:A cross-sectional analysis was conducted of non-Hispanic As...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc15-0299
更新日期:2015-11-01 00:00:00