Multicomponent Healthcare Intervention for Glycemic Control in Type 2 Diabetes

Type 2 diabetes is a chronic condition characterized by high blood sugar levels due to insulin resistance. Poor glycemic control in type 2 diabetic patients, indicated by elevated glycosylated hemoglobin (HbA1c) levels, is associated with an increased risk of complications and worsened health outcomes.

Clinical Trial

A clinical trial evaluated whether a specially designed multicomponent healthcare intervention can improve glycemic control in patients with poorly controlled type 2 diabetes. The trial included patients from 11 primary care centers. The participants had type 2 diabetes and HbA1c levels exceeding 9% (> 75 mmol/mol).

The intervention group comprised 225 patients, receiving a professional and patient-centered approach, which included a dedicated monographic visit to encourage therapeutic intensification by physicians. The control group of 181 patients experienced an identical intervention, except for omitting the dedicated visit. The primary outcome measured was the comparison of HbA1c reductions between the two groups after a 12-month follow-up period.

Results

The mean age of the participants was 59.5 years, with a mean diabetes duration of 10.7 years and a mean HbA1c level of 10.3% (89.0 mmol/mol). After 12 months, patients in the intervention arm achieved significant reductions in HbA1c compared to those in the control group. Additionally, more intervention participants achieved an HbA1c level below 8% and received treatment with more than three antidiabetic therapies. The intervention was the only variable associated with increased odds of achieving an HbA1c level below 8%.

Conclusion

A multicomponent intervention, including a dedicated visit to reduce therapeutic inertia among primary care physicians, can effectively improve glycemic control in patients with poorly controlled type 2 diabetes. The intervention led to significant reductions in HbA1c levels, an increased proportion of patients achieving HbA1c levels below 8%, and more frequent use of multiple antidiabetic therapies. These findings highlight the potential of targeted healthcare interventions in addressing the challenges associated with glycemic control in type 2 diabetes, ultimately improving patient outcomes and quality of life.
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