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Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: The Microalbuminuria Education and Medication Optimisation (MEMO) study
journal contribution
posted on 2023-05-17, 09:11 authored by Crasto, W, Jarvis, J, Khunti, K, Skinner, TC, Gray, LJ, Brela, J, Troughton, J, Daly, H, Lawrence, IG, McNally, PG, Carey, ME, Davies, MJAims To determine whether tighter cardiovascular risk factor control with structured education in individuals with type 2 diabetes (T2DM) and microalbuminuria benefits cardiovascular risk factors. Methods Participants from a multiethnic population, recruited from primary care and specialist clinics were randomised to intensive intervention with structured patient (DESMOND model) education (n = 94) or usual care by own health professional (n = 95). Primary outcome: change in HbA1c at 18 months. Secondary outcomes: changes in blood pressure (BP), cholesterol, albuminuria, proportion reaching risk factor targets, modelled cardiovascular risk scores. Results Mean (SD) age and diabetes duration of participants were 61.5 (10.5) and 11.5 (9.3) years, respectively. At 18 months, intensive intervention showed significant improvements in HbA1c (7.1(1.0) vs. 7.8(1.4)%, p < 0.0001), systolic BP (129(16) vs. 139(17) mmHg, p < 0.0001), diastolic BP (70(11) vs. 76(12) mmHg, p < 0.001), total cholesterol (3.7(0.8) vs. 4.1(0.9) mmol/l, p = 0.001). Moderate and severe hypoglycaemia was 11.2 vs. 29.0%; p = 0.001 and 0 vs. 6.3%; p = 0.07, respectively. More intensive participants achieved ¡Ý3 risk factor targets with greater reductions in cardiovascular risk scores. Conclusions Intensive intervention showed greater improvements in metabolic control and cardiovascular risk profile with lower rates of moderate and severe hypoglycaemia. Intensive glycaemic interventions should be underpinned by structured education promoting self-management in T2DM.
History
Publication title
Diabetes Research and Clinical PracticeVolume
93Pagination
328-336ISSN
0168-8227Department/School
Tasmanian School of MedicinePublisher
Elsevier Sci Ireland LtdPlace of publication
Customer Relations Manager, Bay 15, Shannon Industrial Estate Co, Clare, IrelandRights statement
The definitive version is available at http://www.sciencedirect.comRepository Status
- Restricted