Sustained benefits of primary care initiative for type 2 diabetes
medwireNews: The benefits of a primary care intervention to increase insulin initiation among patients with type 2 diabetes are maintained for up to 2 years, suggest follow-up results from the Stepping Up trial.
The primary trial results showed that the intervention – involving a training session for healthcare providers and ongoing support for 12 months – significantly improved glycated hemoglobin (HbA1c) levels and insulin initiation rates among patients with type 2 diabetes compared with usual care, say Jo-Anne Manski-Nankervis (University of Melbourne, Victoria, Australia) and study co-authors.
At the 24-month follow-up, mean HbA1c levels were significantly lower among the 151 patients attending healthcare centers randomly assigned to receive the intervention compared with the 115 participants enrolled in control practices (7.6 vs 8.0%), and a significantly greater proportion of patients in the intervention group were prescribed insulin (71.3 vs 31.0%).
These findings demonstrate that the benefits of the Stepping Up intervention were “maintained for an additional 12 months after the completion of the initial one-year trial,” write the researchers in Primary Care Diabetes.
However, they note that further improvements in HbA1c levels were not seen after the 1-year follow-up, meaning that “[o]ngoing support and mentorship from [the Stepping Up Registered Nurse-Credentialed Diabetes Educator] may be important in facilitating ongoing improvements.”
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