Premium
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
Author(s) -
Rachmani R.,
Slavachevski I.,
Berla M.,
FrommerShapira R.,
Ravid M.
Publication year - 2005
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2005.01428.x
Subject(s) - medicine , diabetes mellitus , relative risk , retinopathy , blood pressure , prospective cohort study , type 2 diabetes mellitus , diabetic retinopathy , nephropathy , randomized controlled trial , type 2 diabetes , disease , surgery , endocrinology , confidence interval
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 HbA 1c 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.