Document Detail


Factors that influence improvement for patients with poorly controlled type 2 diabetes.
MedLine Citation:
PMID:  16723163     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Assess reasons for improved control for patients with initially poorly controlled diabetes. RESEARCH DESIGN AND METHODS: Patients in seven practices with type 2 diabetes were selected if within a 6-month period they had two glycosylated hemoglobin (HbA1c) levels of at least 8.0%. Patient factors that may influence control were compared for patients grouped according to their last two HbA1c levels. RESULTS: Review of 643 medical records of diabetic patients treated by 29 clinicians identified 69 study patients. After at least 1 year of follow-up 26 patients became well controlled, 14 had intermediate control, and 29 remained in poor control. Becoming controlled was not significantly associated with gender, age, duration of diabetes, BMI, or HbA1c levels prior to baseline. It was inversely associated with greater use of medications (P = 0.04), and positively associated with understanding of diabetes (P = 0.03), adherence to recommendations for meal plan (P = 0.001), and glucose monitoring (P = 0.02). Thirty-one percent of patients who became controlled had a change in life circumstances. Reasons for not advancing medications were probably justified for 69% of patients who remained uncontrolled. CONCLUSION: Improved control depends largely on patient self-care behaviors.
Authors:
Arthur Hartz; Sarah Kent; Paul James; Yinghui Xu; Michael Kelly; Jeanette Daly
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.     Date:  2006-05-24
Journal Detail:
Title:  Diabetes research and clinical practice     Volume:  74     ISSN:  0168-8227     ISO Abbreviation:  Diabetes Res. Clin. Pract.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-10-23     Completed Date:  2007-02-01     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  8508335     Medline TA:  Diabetes Res Clin Pract     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  227-32     Citation Subset:  IM    
Affiliation:
University of Iowa, Carver College of Medicine, Department of Family Medicine, Iowa City, IA, USA. arthur-hartz@uiowa.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose
Diabetes Mellitus, Type 2 / complications,  therapy*
Female
Humans
Hypoglycemic Agents / administration & dosage,  therapeutic use
Insulin / administration & dosage,  therapeutic use
Male
Middle Aged
Patient Compliance
Retrospective Studies
Risk Factors
Self Care*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
5 R03 HS014410/HS/AHRQ HHS; 5 R21 HS013581/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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