ArticlePloS one2012
The impact of adherence to screening guidelines and of diabetes clinics referral on morbidity and mortality in diabetes.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 50 citations in OpenAlex.
- SGLT2 inhibitor role in cardio-metabolic-renal diseases: a narrative review of recent evidence and their pharmacological, clinical and economic implications.Drugs in context · 2026Review
- Study protocol: glycaemic outcomes in people with type 2 diabetes initiating continuous glucose monitoring: the 2GO-CGM study.Journal of diabetes and metabolic disorders · 2023Article
- Doctors' adherence to guidelines recommendations and glycaemic control in diabetic patients in Quetta, Pakistan: Findings from an observational study.Frontiers in medicine · 2022Article
- From swab testing to health outcomes within the T2DM population: Impact of diabetes background on COVID19 progression.Diabetes research and clinical practice · 2021Article
- Diabetes Care in French Guiana: The Gap Between National Guidelines and Reality.Frontiers in endocrinology · 2021Article
- Article
- Exploring geographic variation of and influencing factors for utilization of four diabetes management measures in Swiss population using claims data.BMJ open diabetes research & care · 2020Article
- Adherence to diabetes care process indicators in migrants as compared to non-migrants with diabetes: a retrospective cohort study.International journal of public health · 2019Article
- Article
- Diabetes management in the primary care setting: a comparison of physicians' performance by gender.Primary health care research & development · 2018Article
- Effectiveness of integrated care model for type 2 diabetes: A population-based study in Reggio Emilia (Italy).PloS one · 2018Article
- Utilization of the Behavior Change Wheel framework to develop a model to improve cardiometabolic screening for people with severe mental illness.Implementation science : IS · 2017Article
- Compliance with the faecal calprotectin test in patients with inflammatory bowel disease.United European gastroenterology journal · 2017Article
- Assessing Screening Guidelines for Cardiovascular Disease Risk Factors using Routinely Collected Data.Scientific reports · 2017Article
- Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities: a Ghanaian cohort study.BMC pregnancy and childbirth · 2016Article
- A set of four simple performance measures reflecting adherence to guidelines predicts hospitalization: a claims-based cohort study of patients with diabetes.Patient preference and adherence · 2016Article
- Article
- Sex differences in cardiovascular mortality in diabetics and nondiabetic subjects: a population-based study (Italy).International journal of endocrinology · 2015Article
- Need and disparities in primary care management of patients with diabetes.BMC endocrine disorders · 2014Article
- Resource use and costs of type 2 diabetes patients receiving managed or protocolized primary care: a controlled clinical trial.BMC health services research · 2014Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite the heightened awareness of diabetes as a major health problem, evidence on the impact of assistance and organizational factors, as well as of adherence to recommended care guidelines, on morbidity and mortality in diabetes is scanty. We identified diabetic residents in Torino, Italy, as of 1st January 2002, using multiple independent data sources. We collected data on several laboratory tests and specialist medical examinations to compare primary versus specialty care management of diabetes and the fulfillment of a quality-of-care indicator based on existing screening guidelines (GCI). Then, we performed regression analyses to identify associations of these factors with mortality and cardiovascular morbidity over a 4 year-follow-up. Patients with the lowest degree of quality of care (i.e. only cared for by primary care and with no fulfillment of GCI) had worse RRs for all-cause (1.72 [95% CI 1.57-1.89]), cardiovascular (1.74 [95% CI 1.50-2.01]) and cancer (1.35 [95% CI 1.14-1.61]) mortality, compared with those with the highest quality of care. They also showed increased RRs for incidence of major cardiovascular events up to 2.03 (95% CI 1.26-3.28) for lower extremity amputations. Receiving specialist care itself increased survival, but was far more effective when combined with the fulfillment of GCI. Throughout the whole set of analysis, implementation of guidelines emerged as a strong modifier of prognosis. We conclude that management of diabetic patients with a pathway based on both primary and specialist care is associated with a favorable impact on all-cause mortality and CV incidence, provided that guidelines are implemented.
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