Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2005
Efficacy of intensive multitherapy for patients with type 2 diabetes mellitus: a randomized controlled trial.
Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 8 of them syntheses that pooled it.
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The trial behind it
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Who cites it
20 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes.The Cochrane database of systematic reviews · 2023Pooled it
- The Effects of Dietary Education Interventions on Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2021Pooled it
- Improving type 2 diabetes mellitus glycaemic control through lifestyle modification implementing diet intervention: a systematic review and meta-analysis.European journal of nutrition · 2020Pooled it
- Exercise and diabetes-related cardiovascular disease: systematic review of published evidence from observational studies and clinical trials.Current diabetes reports · 2013Pooled it
- Intensive glycaemic control for patients with type 2 diabetes: systematic review with meta-analysis and trial sequential analysis of randomised clinical trials.BMJ (Clinical research ed.) · 2011Pooled it
- Effectiveness of disease-management programs for improving diabetes care: a meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2011Pooled it
- Behavioural interventions for obese adults with additional risk factors for morbidity: systematic review of effects on behaviour, weight and disease risk factors.Obesity facts · 2010Pooled it
- Diabetes: glycaemic control in type 2.BMJ clinical evidence · 2008Pooled it
- Effects of frequency of follow-up on quality of life of type 2 diabetes patients on oral hypoglycemics.Diabetes technology & therapeutics · 2012Trial
- Effect of exercise interventions based on family management or self-management on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.Diabetology & metabolic syndrome · 2023Review
- Medical Nutrition Therapy Provided by Dietitians is Effective and Saves Healthcare Costs in the Management of Adults with Dyslipidemia.Current atherosclerosis reports · 2023Review
- A narrative review of exercise participation among adults with prediabetes or type 2 diabetes: barriers and solutions.Frontiers in clinical diabetes and healthcare · 2023Review
- Diabetes self-management education: miles to go.Nursing research and practice · 2013Article
- Hypertension and type 2 diabetes: what family physicians can do to improve control of blood pressure--an observational study.BMC family practice · 2011Article
- Drug management for hypertension in type 2 diabetes in family practice.Canadian family physician Medecin de famille canadien · 2009Article
- DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol.BMC endocrine disorders · 2009Article
- Predictors of sustained walking among diabetes patients in managed care: the Translating Research into Action for Diabetes (TRIAD) study.Journal of general internal medicine · 2008Article
- Multitherapy for diabetes.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2006Article
- Multitherapy for diabetes.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2006Article
- Can diabetes management programs create sustained improvements in disease outcomes?CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2005Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNational guidelines for managing diabetes set standards for care. We sought to determine whether a 1-year intensive multitherapy program resulted in greater goal attainment than usual care among patients with poorly controlled type 2 diabetes mellitus.
methodsWe identified patients with poorly controlled type 2 diabetes receiving outpatient care in the community or at our hospital. Patients 30-70 years of age with a hemoglobin A1c concentration of 8% or greater were randomly assigned to receive intensive multitherapy (n = 36) or usual care (n = 36).
resultsThe average hemoglobin A1c concentration at entry was 9.1% (standard deviation [SD] 1%) in the intensive therapy group and 9.3% (SD 1%) in the usual therapy group. By 12 months, a higher proportion of patients in the intensive therapy group than in the control group had achieved Canadian Diabetes Association (CDA) goals for hemoglobin A(1c) concentrations (goal < or = 7.0%: 35% v. 8%), diastolic blood pressure (goal < 80 mm Hg: 64% v. 37%), low-density lipoprotein cholesterol (LDL-C) levels (goal < 2.5 mmol/L: 53% v. 20%) and triglyceride levels (goal < 1.5 mmol/L: 44% v. 14%). There were no significant differences between the 2 groups in attaining the targets for fasting plasma glucose levels, systolic blood pressure or total cholesterol:high-density lipoprotein cholesterol ratio. None of the patients reached all CDA treatment goals. By 18 months, differences in goal attainment were no longer evident between the 2 groups, except for LDL-C levels. Quality of life, as measured by a specific questionnaire, increased in both groups, with a greater increase in the intensive therapy group (13% [SD 10%] v. 6% [SD 13%], p < 0.003).
interpretationIntensive multitherapy for patients with poorly controlled type 2 diabetes is successful in helping patients meet most of the goals set by a national diabetes association. However, 6 months after intensive therapy stopped and patients returned to usual care, the benefits had vanished.
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