Search

AIM: To assess the efficacy of a strategy to improve vascular risk management in patients with type 2 diabetes mellitus (T2DM). METHODS: This was a pilot best practice implementation enhancement programme that enrolled 578 patients with T2DM. A baseline visit was followed by a concerted effort from previously trained physicians to improve adherence to lifestyle advice and optimise drug treatment for all vascular risk factors. The patients were followed-up for 6 months. The UKPDS risk engine was used to estimate vascular risk in patients without established coronary heart disease (CHD) (n = 279). RESULTS: There was an improvement in compliance to lifestyle measures and increased prescription of evidence-based medication. In patients without established CHD there was a 37% reduction in estimated risk for CHD, 44% for fatal CHD, 10% for stroke and 25% for fatal stroke (p < or = 0.003 for all comparisons vs. baseline). There was also a substantial increase in the proportion of patients with established CHD who achieved their vascular risk factor targets. CONCLUSIONS: This is the first study to increase the adherence to multiple interventions in patients with T2DM in both primary care and hospital settings. Education of physicians and patients, distribution of guidelines/brochures, and the completion of a one-page form, motivated both physicians and patients to achieve multiple vascular risk factor goals. [ABSTRACT FROM AUTHOR]

Aim of the Study: To evaluate mean platelet volume (MPV) in type 2 diabetic versus non-diabetic patients, as well as to investigate the associations between MPV and diabetic complications., Materials and Methods: This study included 416 patients divided into two groups. Group A comprised 265 type 2 diabetic patients (131 men) with a mean age of 67.4 +/- 9.5 years and a mean diabetes duration of 14.5 +/- 5.7 years. Group B comprised 151 non-diabetic patients (74 men) with a mean age of 68.6 +/- 9.1 years. MPV (blood samples anticoagulated with sodium citrate) was measured in two blood cell counters (Sysmex SF 3000 and Cell-Dyn 3700)., Results: MPV was significantly higher (P = 0.01) in group A (14.2 +/- 2.2 fl) than in group B (7.1 +/- 1.2 fl). In group A MPV was significantly higher (P = 0.043) in patients with retinopathy (15.8 +/- 1.3 fl) than in patients without retinopathy (10.9 +/- 1.1 fl) and also significantly higher (P = 0.044) in patients with microalbuminuria (15.6 +/- 1.2 fl) than in patients without microalbuminuria (10.1 +/- 1.2 fl). No association, however, was found in group A between MPV and age, gender, duration of diabetes, insulin dependency, BMI, HbA1c, coronary artery disease or dyslipidaemia., Conclusions: MPV is higher in type 2 diabetic patients than in non-diabetic patients. Among type 2 diabetic patients MPV is higher in those who have microvascular complications (retinopathy or microalbuminuria).