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Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: The Microalbuminuria Education and Medication Optimisation (MEMO) study

Citation

Crasto, W and Jarvis, J and Khunti, K and Skinner, TC and Gray, LJ and Brela, J and Troughton, J and Daly, H and Lawrence, IG and McNally, PG and Carey, ME and Davies, MJ, Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: The Microalbuminuria Education and Medication Optimisation (MEMO) study, Diabetes Research and Clinical Practice, 93, (3) pp. 328-336. ISSN 0168-8227 (2011) [Refereed Article]


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DOI: doi:10.1016/j.diabres.2011.05.008

Abstract

Aims 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 3 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.

Item Details

Item Type:Refereed Article
Keywords:diabetes; Microalbuminuria; Structured education
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Geriatrics and Gerontology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Diabetes
Author:Skinner, TC (Professor Timothy Skinner)
ID Code:74231
Year Published:2011
Web of Science® Times Cited:18
Deposited By:Rural Clinical School
Deposited On:2011-11-15
Last Modified:2012-08-27
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