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Teaching and motivating patients to control their risk factors retards progression of cardiovascular as well as microvascular sequelae of Type 2 diabetes mellitus- a randomized prospective 8 years follow-up study
Aims To examine whether motivating patients to gain expertise and closely follow their risk parameters will attenuate the course of microvascular and cardiovascular sequelae of diabetes. Methods A randomized prospective study on 165 patients with diabetes mellitus Type 2, hypertension (> 140/90...
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| Published in: | Diabetic medicine 2005-04, Vol.22 (4), p.410-414 |
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| creator | Rachmani, R. Slavachevski, I. Berla, M. Frommer-Shapira, R. Ravid, M. |
| description | Aims To examine whether motivating patients to gain expertise and closely follow their risk parameters will attenuate the course of microvascular and cardiovascular sequelae of diabetes.
Methods A randomized prospective study on 165 patients with diabetes mellitus Type 2, hypertension (> 140/90 mmHg) and hyperlipidaemia (LDL‐C > 3 mmol/l), referred for consultation to a diabetes clinic in an academic hospital. Patients were randomly allocated to standard consultation (SC) or to a patient participation (PP) and teaching programme. Follow‐up continued by primary care physicians.
Results The mean follow‐up was 7.7 years. SC group patients each attended eight annual consultations. The PP patients initiated on average 1.2 ± 0.8 additional consultations per annum. The relative risk (RR) over 8 years, for the combined cardiovascular event index in the intervention (PP) vs. the control (SC) group was 0.65 (95% CI 0.41–0.89, P = 0.001). Nephropathy developed in 14 vs. 7 patients in the SC and PP groups, respectively, RR 0.50 (95% CI 0.28–0.85, P = 0.02), retinopathy developed in 35 vs. 21 patients, RR 0.60 (95% CI 0.21–0.82, P = 0.03). Throughout the study, period blood pressure, LDL‐C and HbA1c were significantly lower in the PP than in the SC patients.
Conclusion Well‐informed and motivated patients, were more successful in maintaining good control of their risk factors, resulting in reduced cardiovascular risk and slower progression of microvascular disease. |
| doi_str_mv | 10.1111/j.1464-5491.2005.01428.x |
| format | article |
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Methods A randomized prospective study on 165 patients with diabetes mellitus Type 2, hypertension (> 140/90 mmHg) and hyperlipidaemia (LDL‐C > 3 mmol/l), referred for consultation to a diabetes clinic in an academic hospital. Patients were randomly allocated to standard consultation (SC) or to a patient participation (PP) and teaching programme. Follow‐up continued by primary care physicians.
Results The mean follow‐up was 7.7 years. SC group patients each attended eight annual consultations. The PP patients initiated on average 1.2 ± 0.8 additional consultations per annum. The relative risk (RR) over 8 years, for the combined cardiovascular event index in the intervention (PP) vs. the control (SC) group was 0.65 (95% CI 0.41–0.89, P = 0.001). Nephropathy developed in 14 vs. 7 patients in the SC and PP groups, respectively, RR 0.50 (95% CI 0.28–0.85, P = 0.02), retinopathy developed in 35 vs. 21 patients, RR 0.60 (95% CI 0.21–0.82, P = 0.03). Throughout the study, period blood pressure, LDL‐C and HbA1c were significantly lower in the PP than in the SC patients.
Conclusion Well‐informed and motivated patients, were more successful in maintaining good control of their risk factors, resulting in reduced cardiovascular risk and slower progression of microvascular disease.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/j.1464-5491.2005.01428.x</identifier><identifier>PMID: 15787665</identifier><identifier>CODEN: DIMEEV</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject><![CDATA[Adult ; Aged ; Atherosclerosis (general aspects, experimental research) ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Diabetes Complications - prevention & control ; Diabetes Complications - psychology ; diabetes mellitus ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - psychology ; Diabetes. Impaired glucose tolerance ; Diabetic Angiopathies - prevention & control ; diabetic complications ; Diabetic Nephropathies - prevention & control ; Diabetic Retinopathy - prevention & control ; Disease Progression ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Epidemiologic Methods ; Humans ; intensive management ; Medical sciences ; Middle Aged ; Motivation ; Myocardial Infarction - etiology ; Myocardial Infarction - prevention & control ; patient education ; Patient Education as Topic ; Stroke - etiology ; Stroke - prevention & control]]></subject><ispartof>Diabetic medicine, 2005-04, Vol.22 (4), p.410-414</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4678-2b987a4066a0b1650b61000524ecc0c4ecd83eb7e9bf812ba950f3518d428ca13</citedby><cites>FETCH-LOGICAL-c4678-2b987a4066a0b1650b61000524ecc0c4ecd83eb7e9bf812ba950f3518d428ca13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1464-5491.2005.01428.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1464-5491.2005.01428.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16622613$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15787665$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rachmani, R.</creatorcontrib><creatorcontrib>Slavachevski, I.</creatorcontrib><creatorcontrib>Berla, M.</creatorcontrib><creatorcontrib>Frommer-Shapira, R.</creatorcontrib><creatorcontrib>Ravid, M.</creatorcontrib><title>Teaching and motivating patients to control their risk factors retards progression of cardiovascular as well as microvascular sequelae of Type 2 diabetes mellitus- a randomized prospective 8 years follow-up study</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Aims To examine whether motivating patients to gain expertise and closely follow their risk parameters will attenuate the course of microvascular and cardiovascular sequelae of diabetes.
Methods A randomized prospective study on 165 patients with diabetes mellitus Type 2, hypertension (> 140/90 mmHg) and hyperlipidaemia (LDL‐C > 3 mmol/l), referred for consultation to a diabetes clinic in an academic hospital. Patients were randomly allocated to standard consultation (SC) or to a patient participation (PP) and teaching programme. Follow‐up continued by primary care physicians.
Results The mean follow‐up was 7.7 years. SC group patients each attended eight annual consultations. The PP patients initiated on average 1.2 ± 0.8 additional consultations per annum. The relative risk (RR) over 8 years, for the combined cardiovascular event index in the intervention (PP) vs. the control (SC) group was 0.65 (95% CI 0.41–0.89, P = 0.001). Nephropathy developed in 14 vs. 7 patients in the SC and PP groups, respectively, RR 0.50 (95% CI 0.28–0.85, P = 0.02), retinopathy developed in 35 vs. 21 patients, RR 0.60 (95% CI 0.21–0.82, P = 0.03). Throughout the study, period blood pressure, LDL‐C and HbA1c were significantly lower in the PP than in the SC patients.
Conclusion Well‐informed and motivated patients, were more successful in maintaining good control of their risk factors, resulting in reduced cardiovascular risk and slower progression of microvascular disease.</description><subject>Adult</subject><subject>Aged</subject><subject>Atherosclerosis (general aspects, experimental research)</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Diabetes Complications - prevention & control</subject><subject>Diabetes Complications - psychology</subject><subject>diabetes mellitus</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - psychology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Angiopathies - prevention & control</subject><subject>diabetic complications</subject><subject>Diabetic Nephropathies - prevention & control</subject><subject>Diabetic Retinopathy - prevention & control</subject><subject>Disease Progression</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Epidemiologic Methods</subject><subject>Humans</subject><subject>intensive management</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Motivation</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - prevention & control</subject><subject>patient education</subject><subject>Patient Education as Topic</subject><subject>Stroke - etiology</subject><subject>Stroke - prevention & control</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNqNkUFu1DAUhiMEokPhCsgbYJXBdmI7WbBAQ1sQBSQ00KXlOC-tp0mc2k5nhtP0LD0E58FhRp0dIgs_O_5--_f7kwQRPCfxe7uak5znKctLMqcYszkmOS3mm0fJ7GHjcTLDIqdphgU5Sp55v8KY0DIrnyZHhIlCcM5mye8lKH1l-kuk-hp1NphbFablEAv0waNgkbZ9cLZF4QqMQ874a9QoHazzyEFQrvZocPbSgffG9sg2SMefxt4qr8dWOaQ8WkPbTrUz2h02PNyM0CqYNMvtAPd3FNVGVRAgolFiwuhTpJCL9mxnfkE9XeUH0NEpoOL-bgsq-mhs29p1Og7Ih7HePk-eNKr18GJfj5MfpyfLxcf0_NvZp8X781TnXBQprcpCqBxzrnBFOMMVJzj2k-agNdZxrIsMKgFl1RSEVqpkuMkYKerYbq1Idpy82Z0bTcWX-CA743X0rXqwo5eC55RRkrFIvv4nyQXLGSunI4sdGPvkvYNGDs50ym0lwXJKX67kFLKcQpZT-vJv-nITpS_3d4xVB_VBuI87Aq_2QAxAtU3sqjb-wHFOKSdZ5N7tuLVpYfvfBuSHLyfTLOrTnd74AJsHvXLX8Z2ZYPLi65lcfL4oxOl3Jn9mfwCj7eEz</recordid><startdate>200504</startdate><enddate>200504</enddate><creator>Rachmani, R.</creator><creator>Slavachevski, I.</creator><creator>Berla, M.</creator><creator>Frommer-Shapira, R.</creator><creator>Ravid, M.</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>200504</creationdate><title>Teaching and motivating patients to control their risk factors retards progression of cardiovascular as well as microvascular sequelae of Type 2 diabetes mellitus- a randomized prospective 8 years follow-up study</title><author>Rachmani, R. ; Slavachevski, I. ; Berla, M. ; Frommer-Shapira, R. ; Ravid, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4678-2b987a4066a0b1650b61000524ecc0c4ecd83eb7e9bf812ba950f3518d428ca13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Atherosclerosis (general aspects, experimental research)</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Diabetes Complications - prevention & control</topic><topic>Diabetes Complications - psychology</topic><topic>diabetes mellitus</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - psychology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Angiopathies - prevention & control</topic><topic>diabetic complications</topic><topic>Diabetic Nephropathies - prevention & control</topic><topic>Diabetic Retinopathy - prevention & control</topic><topic>Disease Progression</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Epidemiologic Methods</topic><topic>Humans</topic><topic>intensive management</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Motivation</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - prevention & control</topic><topic>patient education</topic><topic>Patient Education as Topic</topic><topic>Stroke - etiology</topic><topic>Stroke - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rachmani, R.</creatorcontrib><creatorcontrib>Slavachevski, I.</creatorcontrib><creatorcontrib>Berla, M.</creatorcontrib><creatorcontrib>Frommer-Shapira, R.</creatorcontrib><creatorcontrib>Ravid, M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rachmani, R.</au><au>Slavachevski, I.</au><au>Berla, M.</au><au>Frommer-Shapira, R.</au><au>Ravid, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Teaching and motivating patients to control their risk factors retards progression of cardiovascular as well as microvascular sequelae of Type 2 diabetes mellitus- a randomized prospective 8 years follow-up study</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2005-04</date><risdate>2005</risdate><volume>22</volume><issue>4</issue><spage>410</spage><epage>414</epage><pages>410-414</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><coden>DIMEEV</coden><notes>ark:/67375/WNG-CKW87FR5-V</notes><notes>ArticleID:DME1428</notes><notes>istex:15F3510287C48856A43B12F3B157E4DFD016D861</notes><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-1</notes><notes>ObjectType-News-3</notes><notes>content type line 23</notes><abstract>Aims To examine whether motivating patients to gain expertise and closely follow their risk parameters will attenuate the course of microvascular and cardiovascular sequelae of diabetes.
Methods A randomized prospective study on 165 patients with diabetes mellitus Type 2, hypertension (> 140/90 mmHg) and hyperlipidaemia (LDL‐C > 3 mmol/l), referred for consultation to a diabetes clinic in an academic hospital. Patients were randomly allocated to standard consultation (SC) or to a patient participation (PP) and teaching programme. Follow‐up continued by primary care physicians.
Results The mean follow‐up was 7.7 years. SC group patients each attended eight annual consultations. The PP patients initiated on average 1.2 ± 0.8 additional consultations per annum. The relative risk (RR) over 8 years, for the combined cardiovascular event index in the intervention (PP) vs. the control (SC) group was 0.65 (95% CI 0.41–0.89, P = 0.001). Nephropathy developed in 14 vs. 7 patients in the SC and PP groups, respectively, RR 0.50 (95% CI 0.28–0.85, P = 0.02), retinopathy developed in 35 vs. 21 patients, RR 0.60 (95% CI 0.21–0.82, P = 0.03). Throughout the study, period blood pressure, LDL‐C and HbA1c were significantly lower in the PP than in the SC patients.
Conclusion Well‐informed and motivated patients, were more successful in maintaining good control of their risk factors, resulting in reduced cardiovascular risk and slower progression of microvascular disease.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>15787665</pmid><doi>10.1111/j.1464-5491.2005.01428.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Aged Atherosclerosis (general aspects, experimental research) Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Diabetes Complications - prevention & control Diabetes Complications - psychology diabetes mellitus Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - psychology Diabetes. Impaired glucose tolerance Diabetic Angiopathies - prevention & control diabetic complications Diabetic Nephropathies - prevention & control Diabetic Retinopathy - prevention & control Disease Progression Endocrine pancreas. Apud cells (diseases) Endocrinopathies Epidemiologic Methods Humans intensive management Medical sciences Middle Aged Motivation Myocardial Infarction - etiology Myocardial Infarction - prevention & control patient education Patient Education as Topic Stroke - etiology Stroke - prevention & control |
| title | Teaching and motivating patients to control their risk factors retards progression of cardiovascular as well as microvascular sequelae of Type 2 diabetes mellitus- a randomized prospective 8 years follow-up study |
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