Cardiology Medical News about screen-detected type 2 diabetes; intensive primary care treatment; cardiovascular risk factors

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Intensive primary care treatment reduced cardiovascular risk factors in screen-detected type 2 diabetes
Evidence-Based Medicine, 08/12/09

Elley RC et al. – In patients with screen–detected type 2 diabetes, an intensive, multifactorial, primary care treatment strategy reduced cardiovascular risk factors more than routine care.

Methods

Cluster–randomised controlled trial
Patients: 498 patients 50–70 years of age (mean age 60 y, 54% men) who were newly diagnosed with type 2 diabetes by a 2–stage screening process. Patients with psychiatric or cognitive disorders, current treatment for cancer, or a poor prognosis were excluded.
Intervention: intensive treatment, including special physician training and frequent follow–up by a diabetes nurse, to lower glucose concentrations (target haemoglobin [Hb] A1c concentration <=7.0%), blood pressure (BP, target <=120/80 mm Hg), and lipid concentrations (target total cholesterol concentration <3.5 mmol/l) combined with structured lifestyle education (37 practices, 255 patients); or routine care according to national guidelines (42 practices, 243 patients).

Results

Outcomes: changes in body mass index, BP, HbA1c concentration, and serum lipid concentrations; and health–related quality of life (Short Form 36).
Patients in the intensive treatment group had greater decreases in most cardiovascular (CV) risk factors than did those in the routine care group.
At 1 year, groups did not differ for health–related quality of life; both groups showed improvements in general health, vitality, and mental health.
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