| Lifestyle counseling in routine care and long-term glucose, blood pressure, and cholesterol control in patients with diabetes. | |
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MedLine Citation:
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PMID: 22275442 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE In clinical trials, diet, exercise, and weight counseling led to short-term improvements in blood glucose, blood pressure, and cholesterol levels in patients with diabetes. However, little is known about the long-term effects of lifestyle counseling on patients with diabetes in routine clinical settings. RESEARCH DESIGN AND METHODS This retrospective cohort study of 30,897 patients with diabetes aimed to determine whether lifestyle counseling is associated with time to A1C, blood pressure, and LDL cholesterol control in patients with diabetes. Patients were included if they had at least 2 years of follow-up with primary care practices affiliated with two teaching hospitals in eastern Massachusetts between 1 January 2000 and 1 January 2010. RESULTS Comparing patients with face-to-face counseling rates of once or more per month versus less than once per 6 months, median time to A1C <7.0% was 3.5 versus 22.7 months, time to blood pressure <130/85 mmHg was 3.7 weeks versus 5.6 months, and time to LDL cholesterol <100 mg/dL was 3.5 versus 24.7 months, respectively (P < 0.0001 for all). In multivariable analysis, one additional monthly face-to-face lifestyle counseling episode was associated with hazard ratios of 1.7 for A1C control (P < 0.0001), 1.3 for blood pressure control (P < 0.0001), and 1.4 for LDL cholesterol control (P = 0.0013). CONCLUSIONS Lifestyle counseling in the primary care setting is strongly associated with faster achievement of A1C, blood pressure, and LDL cholesterol control. These results confirm that the findings of controlled clinical trials are applicable to the routine care setting and provide evidence to support current treatment guidelines. |
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Authors:
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Fritha Morrison; Maria Shubina; Alexander Turchin |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diabetes care Volume: 35 ISSN: 1935-5548 ISO Abbreviation: Diabetes Care Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-01-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7805975 Medline TA: Diabetes Care Country: United States |
Other Details:
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Languages: eng Pagination: 334-41 Citation Subset: IM |
Affiliation:
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Corresponding author: Alexander Turchin, aturchin@partners.org. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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