PMID- 15220240
OWN - NLM
STAT- MEDLINE
DCOM- 20041208
LR  - 20211203
IS  - 0149-5992 (Print)
IS  - 0149-5992 (Linking)
VI  - 27
IP  - 7
DP  - 2004 Jul
TI  - Improving efficacy of diabetes management using treatment algorithms in a mainly 
      Hispanic population.
PG  - 1638-46
AB  - OBJECTIVE: To compare clinical outcomes obtained using treatment algorithms 
      versus standard "usual care" to treat patients with type 2 diabetes in a 
      community setting. RESEARCH DESIGN AND METHODS: An observational group comparison 
      was implemented in three community-based clinics in San Antonio, Texas: 1). a 
      community clinic following treatment algorithms (CC-TA), 2). university clinic 
      following treatment algorithms (UC-TA), and 3). a community clinic following 
      standard "usual care" practices (CC-SC). Three hundred fifty-eight recently 
      diagnosed type 2 diabetic patients (90% Mexican American, from low-income 
      neighborhoods) who were consecutively identified at the three clinics were 
      recruited. Following medical and laboratory evaluation, participants were started 
      on treatment for hyperglycemia, hypertension, and dyslipidemia and followed for 
      12 months. RESULTS: Decrements in HbA(1c) at 12 months in the CC-TA and UC-TA 
      were 3.1 and 3.3%, respectively, compared to 1.3% in the CC-SC (P < 0.0001). 
      Corresponding decrements in fasting plasma glucose at 12 months were 94 and 99 
      mg/dl, respectively, versus 38 mg/dl in CC-SC (P < 0.0001). Reductions in total 
      cholesterol, LDL cholesterol, and triglycerides at 12 months were greater in both 
      algorithm-managed clinics compared to standard care-managed clinics (P < 0.0001). 
      In algorithm-managed clinics, there were 30% more documented eye exams and 24% 
      more documented foot exams than in standard care-managed patients. CONCLUSIONS: 
      Adherence to the treatment algorithms improved metabolic outcomes in type 2 
      diabetic patients to a greater extent than standard care practices. These results 
      have important clinical implications for the treatment of type 2 diabetic 
      patients.
FAU - Fanning, Etta L
AU  - Fanning EL
AD  - Department of Medicine, University of Texas Health Science Center, San Antonio, 
      TX 78284, USA. fanninge@msn.com
FAU - Selwyn, Beatrice J
AU  - Selwyn BJ
FAU - Larme, Anne C
AU  - Larme AC
FAU - DeFronzo, Ralph A
AU  - DeFronzo RA
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Diabetes Care
JT  - Diabetes care
JID - 7805975
SB  - IM
MH  - Adult
MH  - Algorithms
MH  - Community Health Centers
MH  - Diabetes Mellitus, Type 2/psychology/*therapy
MH  - Female
MH  - *Hispanic or Latino
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Compliance
MH  - Patient Selection
MH  - Socioeconomic Factors
MH  - Texas
EDAT- 2004/06/29 05:00
MHDA- 2004/12/16 09:00
CRDT- 2004/06/29 05:00
PHST- 2004/06/29 05:00 [pubmed]
PHST- 2004/12/16 09:00 [medline]
PHST- 2004/06/29 05:00 [entrez]
AID - 27/7/1638 [pii]
AID - 10.2337/diacare.27.7.1638 [doi]
PST - ppublish
SO  - Diabetes Care. 2004 Jul;27(7):1638-46. doi: 10.2337/diacare.27.7.1638.