TY - JOUR
T1 - Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria
T2 - The Microalbuminuria Education and Medication Optimisation (MEMO) study
AU - Crasto, W.
AU - Jarvis, J.
AU - Khunti, K.
AU - Skinner, T. C.
AU - Gray, L. J.
AU - Brela, J.
AU - Troughton, J.
AU - Daly, H.
AU - Lawrence, I. G.
AU - McNally, P. G.
AU - Carey, M. E.
AU - Davies, M. J.
PY - 2011/9/1
Y1 - 2011/9/1
N2 - Aims: To determine whether tighter cardiovascular risk factor control with structured education in individuals with type 2 diabetes (T2DM) and microalbuminuria benefits cardiovascular risk factors. Methods: Participants from a multiethnic population, recruited from primary care and specialist clinics were randomised to intensive intervention with structured patient (DESMOND model) education (n= 94) or usual care by own health professional (n= 95). Primary outcome: change in HbA1c at 18. months. Secondary outcomes: changes in blood pressure (BP), cholesterol, albuminuria, proportion reaching risk factor targets, modelled cardiovascular risk scores. Results: Mean (SD) age and diabetes duration of participants were 61.5 (10.5) and 11.5 (9.3) years, respectively. At 18. months, intensive intervention showed significant improvements in HbA1c (7.1(1.0) vs. 7.8(1.4)%, p< 0.0001), systolic BP (129(16) vs. 139(17) mmHg, p< 0.0001), diastolic BP (70(11) vs. 76(12) mmHg, p< 0.001), total cholesterol (3.7(0.8) vs. 4.1(0.9) mmol/l, p= 0.001). Moderate and severe hypoglycaemia was 11.2 vs. 29.0%; p= 0.001 and 0 vs. 6.3%; p= 0.07, respectively. More intensive participants achieved ≥3 risk factor targets with greater reductions in cardiovascular risk scores. Conclusions: Intensive intervention showed greater improvements in metabolic control and cardiovascular risk profile with lower rates of moderate and severe hypoglycaemia. Intensive glycaemic interventions should be underpinned by structured education promoting self-management in T2DM.
AB - Aims: To determine whether tighter cardiovascular risk factor control with structured education in individuals with type 2 diabetes (T2DM) and microalbuminuria benefits cardiovascular risk factors. Methods: Participants from a multiethnic population, recruited from primary care and specialist clinics were randomised to intensive intervention with structured patient (DESMOND model) education (n= 94) or usual care by own health professional (n= 95). Primary outcome: change in HbA1c at 18. months. Secondary outcomes: changes in blood pressure (BP), cholesterol, albuminuria, proportion reaching risk factor targets, modelled cardiovascular risk scores. Results: Mean (SD) age and diabetes duration of participants were 61.5 (10.5) and 11.5 (9.3) years, respectively. At 18. months, intensive intervention showed significant improvements in HbA1c (7.1(1.0) vs. 7.8(1.4)%, p< 0.0001), systolic BP (129(16) vs. 139(17) mmHg, p< 0.0001), diastolic BP (70(11) vs. 76(12) mmHg, p< 0.001), total cholesterol (3.7(0.8) vs. 4.1(0.9) mmol/l, p= 0.001). Moderate and severe hypoglycaemia was 11.2 vs. 29.0%; p= 0.001 and 0 vs. 6.3%; p= 0.07, respectively. More intensive participants achieved ≥3 risk factor targets with greater reductions in cardiovascular risk scores. Conclusions: Intensive intervention showed greater improvements in metabolic control and cardiovascular risk profile with lower rates of moderate and severe hypoglycaemia. Intensive glycaemic interventions should be underpinned by structured education promoting self-management in T2DM.
KW - Microalbuminuria
KW - Structured education
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=80052732201&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2011.05.008
DO - 10.1016/j.diabres.2011.05.008
M3 - Journal article
C2 - 21640424
AN - SCOPUS:80052732201
SN - 0168-8227
VL - 93
SP - 328
EP - 336
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
IS - 3
ER -
