The excess mortality of patients with diabetes and concurrent psychiatric illness is markedly reduced by structured personal diabetes care. A 19-year follow up of the randomized controlled study Diabetes Care in General Practice (DCGP).

Julie Rask Larsen; Volkert Dirk Siersma; Annette Sofie Davidsen; Frans Boch Waldorff; Susanne Reventlow; Niels de Fine Olivarius

doi:10.1016/j.genhosppsych.2015.10.001

The excess mortality of patients with diabetes and concurrent psychiatric illness is markedly reduced by structured personal diabetes care. A 19-year follow up of the randomized controlled study Diabetes Care in General Practice (DCGP).

Julie Rask Larsen, Volkert Dirk Siersma, Annette Sofie Davidsen, Frans Boch Waldorff, Susanne Reventlow, Niels de Fine Olivarius

11 Citations (Scopus)

Abstract

Objective: To assess the effectiveness of an intervention in Type 2 diabetic patients with concurrent psychiatric illness (PI) and compare this with the effectiveness in patients without PI. Method: In the Diabetes Care in General Practice trial, 1381 patients newly diagnosed with Type 2 diabetes were randomized to 6 years of structured personal diabetes care or routine diabetes care (ClinicalTrials.gov NCT01074762). In this observational post-hoc analysis, the effectiveness of the intervention for diabetes in 179 patients with concurrent PI was analyzed. Results: During the 19-year follow-up period, patients with PI in the structured personal care group experienced a lower risk for all-cause mortality [105.3 vs. 140.4 events per 1000 patient-years; hazard ratio (HR): 0.63, P = 0.023, multivariably adjusted], diabetes-related death (66.0 vs. 95.1; HR: 0.57, P = 0.015), any diabetes-related endpoint (169.5 vs. 417.5; HR: 0.47, P = 0.0009) and myocardial infarction (54.1 vs. 104.4; HR: 0.48, P = 0.013), compared to patients with PI in the routine care group. This translates into a number needed to treat over 10 years of three or lower for these outcomes. Conclusion: These findings suggest that in primary care, structured diabetes care allowing for individualization was highly effective among diabetic patients with co-occurring PI.

Original language	English
Journal	General Hospital Psychiatry
Volume	38
Pages (from-to)	42-52
Number of pages	11
ISSN	0163-8343
DOIs	https://doi.org/10.1016/j.genhosppsych.2015.10.001
Publication status	Published - 1 Jan 2016

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Larsen, J. R., Siersma, V. D., Davidsen, A. S., Waldorff, F. B., Reventlow, S., & Olivarius, N. D. F. (2016). The excess mortality of patients with diabetes and concurrent psychiatric illness is markedly reduced by structured personal diabetes care. A 19-year follow up of the randomized controlled study Diabetes Care in General Practice (DCGP). General Hospital Psychiatry, 38, 42-52. https://doi.org/10.1016/j.genhosppsych.2015.10.001

The excess mortality of patients with diabetes and concurrent psychiatric illness is markedly reduced by structured personal diabetes care. A 19-year follow up of the randomized controlled study Diabetes Care in General Practice (DCGP). / Larsen, Julie Rask; Siersma, Volkert Dirk ; Davidsen, Annette Sofie et al.
In: General Hospital Psychiatry, Vol. 38, 01.01.2016, p. 42-52.

Research output: Contribution to journal › Journal article › Research › peer-review

Larsen, JR, Siersma, VD , Davidsen, AS , Waldorff, FB , Reventlow, S & Olivarius, NDF 2016, 'The excess mortality of patients with diabetes and concurrent psychiatric illness is markedly reduced by structured personal diabetes care. A 19-year follow up of the randomized controlled study Diabetes Care in General Practice (DCGP).', General Hospital Psychiatry, vol. 38, pp. 42-52. https://doi.org/10.1016/j.genhosppsych.2015.10.001

Larsen JR, Siersma VD , Davidsen AS , Waldorff FB , Reventlow S , Olivarius NDF. The excess mortality of patients with diabetes and concurrent psychiatric illness is markedly reduced by structured personal diabetes care. A 19-year follow up of the randomized controlled study Diabetes Care in General Practice (DCGP). General Hospital Psychiatry. 2016 Jan 1;38:42-52. doi: 10.1016/j.genhosppsych.2015.10.001

Larsen, Julie Rask ; Siersma, Volkert Dirk ; Davidsen, Annette Sofie et al. / The excess mortality of patients with diabetes and concurrent psychiatric illness is markedly reduced by structured personal diabetes care. A 19-year follow up of the randomized controlled study Diabetes Care in General Practice (DCGP). In: General Hospital Psychiatry. 2016 ; Vol. 38. pp. 42-52.

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title = "The excess mortality of patients with diabetes and concurrent psychiatric illness is markedly reduced by structured personal diabetes care. A 19-year follow up of the randomized controlled study Diabetes Care in General Practice (DCGP).",

abstract = "Objective: To assess the effectiveness of an intervention in Type 2 diabetic patients with concurrent psychiatric illness (PI) and compare this with the effectiveness in patients without PI. Method: In the Diabetes Care in General Practice trial, 1381 patients newly diagnosed with Type 2 diabetes were randomized to 6 years of structured personal diabetes care or routine diabetes care (ClinicalTrials.gov NCT01074762). In this observational post-hoc analysis, the effectiveness of the intervention for diabetes in 179 patients with concurrent PI was analyzed. Results: During the 19-year follow-up period, patients with PI in the structured personal care group experienced a lower risk for all-cause mortality [105.3 vs. 140.4 events per 1000 patient-years; hazard ratio (HR): 0.63, P = 0.023, multivariably adjusted], diabetes-related death (66.0 vs. 95.1; HR: 0.57, P = 0.015), any diabetes-related endpoint (169.5 vs. 417.5; HR: 0.47, P = 0.0009) and myocardial infarction (54.1 vs. 104.4; HR: 0.48, P = 0.013), compared to patients with PI in the routine care group. This translates into a number needed to treat over 10 years of three or lower for these outcomes. Conclusion: These findings suggest that in primary care, structured diabetes care allowing for individualization was highly effective among diabetic patients with co-occurring PI.",

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AU - Davidsen, Annette Sofie

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N2 - Objective: To assess the effectiveness of an intervention in Type 2 diabetic patients with concurrent psychiatric illness (PI) and compare this with the effectiveness in patients without PI. Method: In the Diabetes Care in General Practice trial, 1381 patients newly diagnosed with Type 2 diabetes were randomized to 6 years of structured personal diabetes care or routine diabetes care (ClinicalTrials.gov NCT01074762). In this observational post-hoc analysis, the effectiveness of the intervention for diabetes in 179 patients with concurrent PI was analyzed. Results: During the 19-year follow-up period, patients with PI in the structured personal care group experienced a lower risk for all-cause mortality [105.3 vs. 140.4 events per 1000 patient-years; hazard ratio (HR): 0.63, P = 0.023, multivariably adjusted], diabetes-related death (66.0 vs. 95.1; HR: 0.57, P = 0.015), any diabetes-related endpoint (169.5 vs. 417.5; HR: 0.47, P = 0.0009) and myocardial infarction (54.1 vs. 104.4; HR: 0.48, P = 0.013), compared to patients with PI in the routine care group. This translates into a number needed to treat over 10 years of three or lower for these outcomes. Conclusion: These findings suggest that in primary care, structured diabetes care allowing for individualization was highly effective among diabetic patients with co-occurring PI.

AB - Objective: To assess the effectiveness of an intervention in Type 2 diabetic patients with concurrent psychiatric illness (PI) and compare this with the effectiveness in patients without PI. Method: In the Diabetes Care in General Practice trial, 1381 patients newly diagnosed with Type 2 diabetes were randomized to 6 years of structured personal diabetes care or routine diabetes care (ClinicalTrials.gov NCT01074762). In this observational post-hoc analysis, the effectiveness of the intervention for diabetes in 179 patients with concurrent PI was analyzed. Results: During the 19-year follow-up period, patients with PI in the structured personal care group experienced a lower risk for all-cause mortality [105.3 vs. 140.4 events per 1000 patient-years; hazard ratio (HR): 0.63, P = 0.023, multivariably adjusted], diabetes-related death (66.0 vs. 95.1; HR: 0.57, P = 0.015), any diabetes-related endpoint (169.5 vs. 417.5; HR: 0.47, P = 0.0009) and myocardial infarction (54.1 vs. 104.4; HR: 0.48, P = 0.013), compared to patients with PI in the routine care group. This translates into a number needed to treat over 10 years of three or lower for these outcomes. Conclusion: These findings suggest that in primary care, structured diabetes care allowing for individualization was highly effective among diabetic patients with co-occurring PI.

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