No abstract

No abstract

OBJECTIVE:To develop and test an inexpensive visual tool to help patients with diabetes improve glycemic control. METHODS:A multidisciplinary team developed a 1-page form, the``Take-home Diabetes Record'' (THDR), providing feedback to patients by displaying percent glycosylated hemoglobin (GHb) values graphically over time, with target levels highlighted. Patients with type 2 diabetes in an inner-city clinic were randomized to THDR use (n = 57) or not (n = 70) over 15 months. Self-care activities were discussed, linked with GHb results, and charted at each clinic visit. Initial and final GHb were compared. RESULTS:Mean GHb fell significantly in THDR patients (À0.94, P = .003), but not in control patients (À0.18, P = .36). Mean GHb decrease was greater in THDR patients (P = .047). A greater proportion of THDR patients (51%) than control patients (18%) achieved a decrease in GHb !0.9 (P = .001).CONCLUSIONS: A graph linking GHb and self-care activities shows promise for improving glycemic control.

Thymic involution following peritoneal sepsis is associated with increased thymocyte programmed cell death. Thymocyte apoptosis induced by sepsis may be the result, in part, of inhibition of IL-2 gene expression.