Brief, cost-effective interventions to promote diabetes self-management are needed. This study evaluated the effects of a brief, regular, proactive, telephone "coaching" intervention delivered by paraprofessionals on diabetes adherence, glycemic control, diabetes-related medical symptoms, and depressive symptoms. Therapeutic mechanisms underlying the intervention's effect on the primary outcomes were also examined. Adults diagnosed with type 2 diabetes (N = 62) were randomly assigned to receive the "coaching" intervention and treatment as usual, or only treatment as usual. The intervention increased frequency of exercise and feet inspection, improved diet, reduced diabetes medical symptoms, and lowered depressive symptoms. Self-efficacy, reinforcement, and awareness of self-care goals mediated the treatment effect on depression, exercise, and feet inspection, respectively. A brief telephone intervention delivered by paraprofessionals had positive effects on type 2 diabetes patients.

Objective: To examine the persistence of the original treatment effects 10 years after the Diabetes Control and Complications Trial (DCCT) in the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study. In the DCCT, intensive therapy aimed at nearnormal glycemia reduced the risk of microvascular complications of type 1 diabetes mellitus compared with conventional therapy.Methods: Retinopathy was evaluated by fundus photography in 1211 subjects at EDIC year 10. Further 3-step progression on the Early Treatment Diabetic Retinopathy Study scale from DCCT closeout was the primary outcome.Results: After 10 years of EDIC follow-up, there was no significant difference in mean glycated hemoglobin levels (8.07% vs 7.98%) between the original treatment groups. Nevertheless, compared with the former conven-tional treatment group, the former intensive group had significantly lower incidences from DCCT close of further retinopathy progression and proliferative retinopathy or worse (hazard reductions, 53%-56%; PϽ.001). The risk (hazard) reductions at 10 years of EDIC were attenuated compared with the 70% to 71% over the first 4 years of EDIC (PϽ.001). The persistent beneficial effects of former intensive therapy were largely explained by the difference in glycated hemoglobin levels during DCCT. Conclusion:The persistent difference in diabetic retinopathy between former intensive and conventional therapy ("metabolic memory") continues for at least 10 years but may be waning.

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Background A test that helps predict the time to the final menstrual period (FMP) has been sought for many years. Objective To assess the ability of antimullerian hormone (AMH) measurements to predictions the time to FMP. Design Prospective longitudinal cohort study. Setting The Study of Women’s Health Across the Nation. Participants and Measurements AMH and FSH were measured in 1537 pre- or early perimenopausal women, mean age 47.5 ± 2.6 years at baseline, then serially until 12 months of amenorrhea occurred. AMH was measured using a 2-site ELISA with a detection limit of 1.85 pg/mL. Main Outcome Measure Areas under the receiver operating curves (AUC) for AMH-based and FSH-based predictions of time to FMP, stratified by age. Probabilities that women would undergo their FMP in the next 12, 24, or 36 months across a range of AMH values were assessed. Results AUCs for predicting that the FMP will occur within the next 24 months were significantly greater for AMH-based than FSH-based models. The probability that a woman with an AMH <10 pg/mL would undergo her FMP within the next 12 months ranged from 51% at h<48 years of age to 79% at ≥51 years. The probability that a woman with an AMH >100 pg/mL would not undergo her FMP within the next 12 months ranged from 97% in women <48 years old to 90% in women ≥51 years old. Conclusions AMH measurement helps estimate when a woman will undergo her FMP, and, in general, does so better than FSH.

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