Diabetes Care and Patient-Oriented Outcomes
JAMAPublished 12 May 1999
Michael Berger
Citations68
SJR quartileQ1
SJR score5.35
SNIP10.71
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TL;DR
To improve standards and outcomes of diabetes care, efforts in the following areas appear crucial: diagnostic procedures and therapeutic management must be evidence-based; patients need to become more actively involved in their disease management; and every center/geographic area needs to perform quality assessment based on patient-oriented outcomes.
Abstract
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Keywords
Medicine
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Intensive therapy effectively delays the onset and slows the progression of diabetic retinopathy, nephropathy, and neuropathy in patients with IDDM.
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20,069 Citations1998
The effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.
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8,213 Citations1998
Since intensive glucose control with metformin appears to decrease the risk of diabetes-related endpoints in overweight diabetic patients, and is associated with less weight gain and fewer hypoglycaemic attacks than are insulin and sulphonylureas, it may be the first-line pharmacological therapy of choice in these patients.
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Insulin-glucose infusion followed by intensive subcutaneous insulin in diabetic patients with acute myocardial infarction improves long term survival, and the effect seen at one year continues for at least 3.5 years, with an absolute reduction in mortality.
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266 Citations1987Ingrid Mühlhauser, I Bruckner +6 more
Under the condition that insulin treatment is based upon a structured and comprehensive training of the patient, intensified insulin injection therapy performed as routine treatment of Type 1 diabetes significantly lowers HbA1 levels without increasing the risk of severe hypoglycaemia.
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215 Citations1998Rocco L. Brunelle, Julie Llewelyn +3 more
It is demonstrated that in type 1 diabetic patients, the frequency of severe hypoglycemia can be reduced by taking insulin lispro as compared with regular human insulin therapy.
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214 Citations1994David H. Wasserman, Bernard Zinman
The scientific information necessary to assess therationale for recommending regular exercise to individuals with IDDM and to develop guidelines for integrating daily exercise with insulin treatment and dietary management are provided.
JAMAStarting Insulin Therapy in Patients With Type 2 Diabetes
204 Citations1997Rodney A. Hayward
For patients with type 2 diabetes who were cared for by generalist physicians, starting insulin therapy was generally safe and effective in achieving moderate glycemic control in patients who initially had poor glycemic Control.
DiabetologiaIntensified insulin therapy and the risk of severe hypoglycaemia
183 Citations1997S. Bott, U. Bott +2 more
No linear or exponential relationship between HbA1 c and severe hypoglycaemia could be identified by using simple group comparisons, and various patient-related predictors of severe hypglycaemia were identified.
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162 Citations1995Thomas R. Pieber, Gernot Brunner +4 more
A structured outpatient DTTP as used in this study is able to improve overall metabolic control and decrease the frequency of severe hypoglycemia in patients with IDDM.
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145 Citations1998H.‐H. Parving
Keywords Type I and Type II diabetes, microalbuminuria, diabetic nephropathy, antihypertensive treatment, angiotensin converting inhibition, renal progression promoters, insertion/deletion polymorphism of angiotENSin converting enzyme gene, end stage renal failure, glycaemic control.
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143 Citations1988Peter Kronsbein, Ingrid Mühlhauser +4 more
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119 Citations1997James G. Kotsanos, Louis Vignati +9 more
Treatment satisfaction and treatment flexibility were significantly improved in patients with type I diabetes using insulin lispro, and other HRQOL findings were comparable for insulin l ispro and regular human insulin.
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88 Citations1994Е. Г. Старостина, М. Б. Анциферов +7 more
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79 Citations1998Ingrid Mühlhauser, H. Overmann +6 more
Accumulated standards of care are high with respect to the implementation of intensified treatment regimens, the level of patient education achieved, treatment control and eye care, whereas areas for improvement are blood pressure control and preventive measures for foot care.
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78 Citations1998Marco Pahor, Bruce M. Psaty +1 more
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58 Citations1995Peter T. Sawicki, I. M x FC hlhauser +4 more
Participation in a treatment programme aimed at intensification of antihypertensive therapy is associated with a reduction of mortality in hypertensive type 1 diabetic patients with overt nephropathy, and blood pressure control was significantly improved in patients who were subjected to intensified antihyertensive therapy.
Diabetic MedicineImplementation of Intensified Insulin Therapy: a European Perspective
52 Citations1995Michael Berger, Ingrid Mühlhauser
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48 Citations1993Ingrid Mühlhauser, Michael Berger
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48 Citations1995Ingrid Mühlhauser, U. Bott +5 more
Strict dietary regimen are not necessary in the context of intensified insulin therapy, according to the objective to document that strict dietary regimen is not necessary.
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48 Citations1999Ulrich Müller, M Femerling +6 more
The ASD quality circle represents a model to improve principal aspects of type 1 diabetes care on a nationwide basis and has attempted to document and to improve the quality of the structure and process of type 2 diabetes care in its participating institutions by a system of peer supervision.
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25 Citations1997Michael Berger, Lutz Heinemann
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22 Citations1996Michael Berger
The European Association for the Study of Diabetes appears to be the ideal forum for such a confrontation and cooperation, a forum of critical appraisal and hope for serendipity to bring scientists and clinicians together in order to improve understanding, prevention and treatment of diabetes.