PMID- 22768889
OWN - NLM
STAT- MEDLINE
DCOM- 20130705
LR  - 20221207
IS  - 1932-2968 (Electronic)
IS  - 1932-2968 (Linking)
VI  - 6
IP  - 3
DP  - 2012 May 1
TI  - Development and validation of a computer application to aid the physician's 
      decision-making process at the start of and during treatment with insulin in type 
      2 diabetes: a randomized and controlled trial.
PG  - 581-8
AB  - BACKGROUND: Achieving optimum blood glucose control in patients with type 2 
      diabetes mellitus (T2DM) is difficult. Some primary care physicians (PCPs) delay 
      the start of insulin use because of the uncertainty in intensifying insulin 
      therapy. The objective was to develop and validate a computer application (CA) 
      that helps PCPs to make decisions about insulin therapy in order to achieve a 
      significant improvement in glycated hemoglobin (HbA1c). METHODS: This was a 
      cluster-randomized clinical trial. Fourteen primary care centers (PCCs) in Madrid 
      with 66 PCPs and 697 T2DM patients on insulin therapy were randomly divided into 
      two groups of seven PCCs each. In the intervention group, seven PCCs included 39 
      PCPs and 365 T2DM patients on insulin therapy. These PCPs were free to use the 
      CA. A further seven PCCs were assigned to the control group with 27 PCPs and 332 
      T2DM patients on insulin therapy. The control group did not use the CA. The 
      duration of the trial was 18 months to validate the CA. The outcome was a change 
      in HbA1c from baseline. RESULTS: In the intervention group, the final HbA1c was 
      7.19% (standard deviation [SD] +/- 0.93), with a difference from the start of 
      -0.69% (p = .001). In the control group, it was 7.71% (SD +/- 1.37), with a 
      difference from the start of -0.09% (p not significant). CONCLUSIONS: This CA 
      helps to improve HbA1c figures of T2DM patients with insulin when it is used by 
      PCPs to make decisions when starting, continuing, or changing insulin and its 
      dosage.
CI  - (c) 2012 Diabetes Technology Society.
FAU - Saenz, Antonio
AU  - Saenz A
AD  - Centro de Salud Pozuelo 1, Pozuelo de Alarcon, Madrid, Spain. 
      asaenzcalvo@telefonica.net
FAU - Brito, Miguel
AU  - Brito M
FAU - Moron, Ignacio
AU  - Moron I
FAU - Torralba, Amalia
AU  - Torralba A
FAU - Garcia-Sanz, Elena
AU  - Garcia-Sanz E
FAU - Redondo, Jesus
AU  - Redondo J
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20120501
PL  - United States
TA  - J Diabetes Sci Technol
JT  - Journal of diabetes science and technology
JID - 101306166
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Aged
MH  - Algorithms
MH  - Biomarkers/blood
MH  - Blood Glucose/drug effects/metabolism
MH  - *Decision Support Systems, Clinical
MH  - *Decision Support Techniques
MH  - Diabetes Mellitus, Type 2/blood/diagnosis/*drug therapy
MH  - Drug Administration Schedule
MH  - *Drug Therapy, Computer-Assisted
MH  - Female
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemic Agents/*administration & dosage
MH  - Insulin/*administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Primary Health Care
MH  - Reproducibility of Results
MH  - Software
MH  - Spain
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC3440036
EDAT- 2012/07/10 06:00
MHDA- 2013/07/06 06:00
PMCR- 2013/05/01
CRDT- 2012/07/10 06:00
PHST- 2012/07/10 06:00 [entrez]
PHST- 2012/07/10 06:00 [pubmed]
PHST- 2013/07/06 06:00 [medline]
PHST- 2013/05/01 00:00 [pmc-release]
AID - dst.6.3.0581 [pii]
AID - 10.1177/193229681200600313 [doi]
PST - epublish
SO  - J Diabetes Sci Technol. 2012 May 1;6(3):581-8. doi: 10.1177/193229681200600313.