Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes

Kim, Hun-Sung; Kim, Hyun-Ah; Yang, Hae Kyung; Lee, Eun Young; Jeong, Yoseok; Kim, Tong Min; Yang, So Jung; Baik, Seo Yeon; Lee, Seung Hwan; Cho, Jae Hyoung; Choi, In Young; Yim, Hyeon Woo; Yun, Bong

doi:10.4093/dmj.2017.41.3.187

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…Our team has conducted several studies on RWE and has built various CDMs [8, 15, 19, 26], but many methodological errors remain to be corrected. In many existing RWEs, it is often the case that a large sample size offers an appealing advantage over RCTs.…”

Section: Discussionmentioning

confidence: 99%

Developing a multi-center clinical data mart of ACEI and ARB for real-world evidence (RWE)

et al. 2018

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BackgroundRandomized controlled trials can be expensive and time-consuming, leading to medical researchers utilizing real-world evidence (RWE) based on already-collected data. We aimed to conduct various RWE studies on angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blocker (ARB), commonly used as first-line therapy for blood pressure, and to develop a multi-center clinical data mart (CDM) of ACEI/ARB for various clinical purposes.MethodsData from electronic medical records of St. Mary’s Hospital and the Seoul National University Hospital were collected. We obtained blood and urine test results of patients within the 30 days prior to their first prescription of ACEI or ARB, as well as the first date of diagnosis and presence of various chronic and cardiovascular diseases using the International Classification of Diseases-10 classification. One researcher managed data quality and collation for each hospital in order to facilitate patient anonymity. When results were unclear, the responsible investigator for each hospital attempted to resolve ambiguities by direct chart review.ResultsA total of 102,333 patients who were prescribed ACEI or ARB for the first time were included (21,481 ACEI, 80,551 ARB, and 301 both). Our ACEI/ARB-CDM included short-term studies (within 12 months) to observe changes in various blood or urinary laboratory test values after the initial prescription of ACEI or ARB and long-term studies to confirm the incidence of various diseases.ConclusionWe established a CDM of RWE for ACEI/ARB prescription, which included various clinical studies. As we accumulate experience in this process, we expect that the use of RWE research will grow and develop.

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Section: Discussionmentioning

confidence: 99%

Developing a multi-center clinical data mart of ACEI and ARB for real-world evidence (RWE)

et al. 2018

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“…Lifestyle management, including diabetes self-management education, nutrition therapy, and physical activity, is a fundamental aspect of the successful management of diabetes [ 1 , 2 ]. Previous studies [ 1 ] have demonstrated that diabetes self-management education improves self-management, diabetes knowledge, satisfaction and quality of life, and glycemic control, and also reduces health care costs.…”

Section: Introductionmentioning

confidence: 99%

Effect of Voluntary Participation on Mobile Health Care in Diabetes Management: Randomized Controlled Open-Label Trial

Lee¹,

Yoo²,

Min³

et al. 2020

JMIR Mhealth Uhealth

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Background The role of mobile health care (mHealth) in glycemic control has been investigated, but its impact on self-management skills and its psychological aspects have not been studied. Objective We evaluated the efficacy of mHealth-based diabetes self-management education and the effect of voluntary participation on its effects. Methods This study was a randomized controlled open-label trial conducted for 6 months at Kangbuk Samsung Hospital. Participants in the control group (n=31) maintained their previous diabetes management strategies. Participants in the intervention group (n=41) additionally received mHealth-based diabetes self-management education through a mobile app and regular individualized feedback from health care professionals. The primary outcome was change in glycated hemoglobin (HbA1c) level over 6 months between the 2 groups (intervention versus control) and within each group (at 6 months versus baseline). The secondary outcomes were changes in body mass index, blood pressure, lipid profile, and questionnaire scores (the Korean version of the Summary of Diabetes Self-Care Activities Questionnaire, an Audit of Diabetes Dependent Quality of Life, the Appraisal of Diabetes Scale, and Problem Areas in Diabetes) over 6 months between groups and within each group. Results A total of 66 participants completed this study. HbA1c (P=.04), total cholesterol level (P=.04), and Problem Areas in Diabetes scores (P=.02) significantly decreased; total diet (P=.03) and self-monitoring of blood glucose level scores (P=.01), based on the Summary of Diabetes Self-Care Activities Questionnaire, markedly increased within the intervention group. These significant changes were observed in self-motivated participants who were recruited voluntarily via advertisements. Conclusions mHealth-based diabetes self-management education was effective at improving glycemic control and diabetes self-management skills and lowering diabetes-related distress in voluntary participants. Trial Registration ClinicalTrials.gov NCT03468283; http://clinicaltrials.gov/ct2/show/NCT03468283

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Management Status of Patients with Type 2 Diabetes Mellitus at General Hospitals in Korea: A 5-Year Follow-Up Study

Jung¹,

Lee²,

Jang³

et al. 2022

J Korean Diabetes

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Background: This study aimed to explore the long-term management of diabetes patients in domestic general hospitals by reviewing 2013 and 2018 data on diabetes management status.Methods: Of 1,802 type 2 diabetes patients who received outpatient treatment at nine general hospitals in Korea and who participated in the 2013 study, 1,124 were enrolled in this study. General characteristics, comorbidities, complications, and management were investigated through medical records.Results: The average age of the subjects was 65.4 ± 10.6 years, the average duration of diabetes mellitus was 15.6 ± 8.0 years, and 58.2% of the subjects had a family history of diabetes. Concomitant diseases were hypertension in 63.0% and dyslipidemia in 78.8%. Diabetic retinopathy was observed in 31.5%, nephropathy in 24.6%, and neuropathy in 24.5%. The mean glycosylated hemoglobin (HbA1c) level was 7.4 ± 2.2% and according to Korean Diabetes Association guidelines, 20.4% of patients with diabetes achieved a HbA1c level of < 6.5%, 70.1% achieved a blood pressure of < 140/85 mm Hg, and 77.1% achieved a low density lipoprotein cholesterol level of < 100 mg/dL. The target achievement rate was 12.5% for blood sugar, blood pressure, and lipid parameters.Conclusion: In diabetes management, blood sugar control was poor compared to blood pressure and lipid control. A systematic management plan is needed to ensure proper blood sugar control.

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Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes

Cited by 3 publications

References 19 publications

Developing a multi-center clinical data mart of ACEI and ARB for real-world evidence (RWE)

Developing a multi-center clinical data mart of ACEI and ARB for real-world evidence (RWE)

Effect of Voluntary Participation on Mobile Health Care in Diabetes Management: Randomized Controlled Open-Label Trial

Management Status of Patients with Type 2 Diabetes Mellitus at General Hospitals in Korea: A 5-Year Follow-Up Study

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