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Efficacy of intensive multitherapy for patients with type 2 diabetes mellitus: a randomized controlled trial.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Ménard, Julie Payette, Hélène A. Baillargeon, Jean-Patrice Maheux, Pierre Lepage, Serge Tessier, Daniel M. Ardilouze, J. L. |
| Copyright Year | 2005 |
| Abstract | BACKGROUND National guidelines for managing diabetes set standards for care. We sought to determine whether a 1-year intensive multitherapy program resulted in greater goal attainment than usual care among patients with poorly controlled type 2 diabetes mellitus. METHODS We identified patients with poorly controlled type 2 diabetes receiving outpatient care in the community or at our hospital. Patients 30-70 years of age with a hemoglobin A1c concentration of 8% or greater were randomly assigned to receive intensive multitherapy (n = 36) or usual care (n = 36). RESULTS The average hemoglobin A1c concentration at entry was 9.1% (standard deviation [SD] 1%) in the intensive therapy group and 9.3% (SD 1%) in the usual therapy group. By 12 months, a higher proportion of patients in the intensive therapy group than in the control group had achieved Canadian Diabetes Association (CDA) goals for hemoglobin A(1c) concentrations (goal < or = 7.0%: 35% v. 8%), diastolic blood pressure (goal < 80 mm Hg: 64% v. 37%), low-density lipoprotein cholesterol (LDL-C) levels (goal < 2.5 mmol/L: 53% v. 20%) and triglyceride levels (goal < 1.5 mmol/L: 44% v. 14%). There were no significant differences between the 2 groups in attaining the targets for fasting plasma glucose levels, systolic blood pressure or total cholesterol:high-density lipoprotein cholesterol ratio. None of the patients reached all CDA treatment goals. By 18 months, differences in goal attainment were no longer evident between the 2 groups, except for LDL-C levels. Quality of life, as measured by a specific questionnaire, increased in both groups, with a greater increase in the intensive therapy group (13% [SD 10%] v. 6% [SD 13%], p < 0.003). INTERPRETATION Intensive multitherapy for patients with poorly controlled type 2 diabetes is successful in helping patients meet most of the goals set by a national diabetes association. However, 6 months after intensive therapy stopped and patients returned to usual care, the benefits had vanished. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://www.cmaj.ca/content/173/12/1457.full.pdf |
| PubMed reference number | 16293781v1 |
| Volume Number | 173 |
| Issue Number | 12 |
| Journal | CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Cholesterol Diabetes Mellitus Diabetes Mellitus, Non-Insulin-Dependent Diastole Eighty Glucose Hemoglobin A Lipoproteins Mercury Patients PersonNameUse - assigned Triglycerides ambulatory care services benefit millimole standards characteristics |
| Content Type | Text |
| Resource Type | Article |
