PMID- 32317264
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231111
IS  - 2398-3795 (Electronic)
IS  - 2398-3795 (Linking)
VI  - 4
IP  - 2
DP  - 2020
TI  - Evaluating the effectiveness of a support programme for people with type 2 
      diabetes mellitus in primary care: an observational prospective study in Ecuador.
LID - bjgpopen20X101025 [pii]
LID - 10.3399/bjgpopen20X101025 [doi]
AB  - BACKGROUND: The success of primary health care relies on the integration of 
      empowered practitioners with cooperative patients regardless of socioeconomic 
      status. Using resources efficiently would help to improve healthcare promotion 
      and reduce complications of chronic non-communicable diseases (NCDs). The 
      importance of network support programmes relies on the fact that they allow to 
      accurately deliver medical care by shaping a sense of community and purpose among 
      the patients. AIM: To evaluate the effectiveness of a network support programme 
      for patients with type 2 diabetes mellitus (T2DM). DESIGN & SETTING: A 
      centre-based observational prospective study took place in a primary care setting 
      in Ecuador. METHOD: The impact of the diabetes care programme was assessed by 
      comparing initial and final metabolic characteristics and outcomes of 593 
      patients with T2DM, followed-up from April 2007 to December 2017, using paired 
      sample t-test. Electrocardiograms (ECGs), ankle-brachial indexes (ABIs), ocular 
      fundus, and monofilament neuropathy tests were assessed with the McNemar test to 
      evaluate complications at the beginning and end of the study. RESULTS: Glycated 
      haemoglobin (HbA1c), lipid profile, and systolic blood pressure (SBP) showed 
      statistically significant decreases between the initial measurement (IMs) and 
      final measurements (FMs). In the FM, significantly lower HbA1c, diastolic blood 
      pressure (DBP), and atherogenic index were found. Despite the length of time 
      since diagnosis, during the follow-up time, long-term micro- and macro-vascular 
      complications, such as ocular fundus, serum creatinine, and ABI, remained 
      unchanged throughout the period of active participation in this healthcare 
      programme. CONCLUSION: This study demonstrates the feasibility of reducing plasma 
      glucose, plasma lipids, and long-term complications in patients with T2DM by 
      implementing a network support programme, which involves the medical team and 
      patients themselves in an environment with limited resources.
CI  - Copyright (c) 2020, The Authors.
FAU - Barrera-Guarderas, Francisco
AU  - Barrera-Guarderas F
AD  - College of Medicine, Pontifical Catholic University of Ecuador, Quito, Ecuador.
FAU - De la Torre-Cisneros, Katherine
AU  - De la Torre-Cisneros K
AUID- ORCID: 0000-0003-2654-0171
AD  - College of Medical Sciences, State University of Southern Manabi, Jipijapa, 
      Ecuador katherine.delatorre@unesum.edu.ec.
FAU - Barrionuevo-Tapia, Maria
AU  - Barrionuevo-Tapia M
AD  - College of Medicine, Pontifical Catholic University of Ecuador, Quito, Ecuador.
FAU - Cabezas-Escobar, Carmen
AU  - Cabezas-Escobar C
AD  - College of Medicine, Pontifical Catholic University of Ecuador, Quito, Ecuador.
LA  - eng
PT  - Journal Article
DEP - 20200623
PL  - England
TA  - BJGP Open
JT  - BJGP open
JID - 101713531
PMC - PMC7330222
OTO - NOTNLM
OT  - diabetes mellitus
OT  - health systems
OT  - non-communicable diseases
OT  - primary health care
EDAT- 2020/04/23 06:00
MHDA- 2020/04/23 06:01
PMCR- 2020/04/22
CRDT- 2020/04/23 06:00
PHST- 2019/09/24 00:00 [received]
PHST- 2019/10/24 00:00 [accepted]
PHST- 2020/04/23 06:00 [pubmed]
PHST- 2020/04/23 06:01 [medline]
PHST- 2020/04/23 06:00 [entrez]
PHST- 2020/04/22 00:00 [pmc-release]
AID - bjgpopen20X101025 [pii]
AID - 01025 [pii]
AID - 10.3399/bjgpopen20X101025 [doi]
PST - epublish
SO  - BJGP Open. 2020 Jun 23;4(2):bjgpopen20X101025. doi: 10.3399/bjgpopen20X101025. 
      Print 2020.