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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EAdult diabetic patients who receive structured education in addition to appropriate pharmacologic intervention have significant and lasting improvements in glycemic control compared with patients who receive usual care. This article presents the results of a study designed to assess the efficacy of a combined structured approach in a diabetes day clinic compared with periodic visits to a typical outpatient clinic.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHyperglycemia\/Hypoglycemia\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHyperglycemia\/Hypoglycemia\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EAdult diabetic patients who receive structured education in addition to appropriate pharmacologic intervention have significant and lasting improvements in glycemic control compared with patients who receive usual care. Velimir Altabas, MD, Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Hospital Center, Zagreb, Croatia, presented the results of a study designed to assess the efficacy of a combined structured approach in a diabetes day clinic compared with periodic visits to a typical outpatient clinic.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe study included adult diabetic patients (\u223c 60% men; mean age \u223c 60 years) treated at a day clinic (n = 140) or in the typical outpatient setting (n = 140). Patients at the day clinic received the usual care provided in an outpatient setting (eg, treatment adjustment and screening for diabetic complications), along with structured theoretical and practical education on topics such as nutrition and diet therapy, proper physical activity, weight control, hypoglycemia, diabetic neuropathy, and diabetic foot. They also watched demonstrations on the use of insulin pens and glucose self-monitoring devices and received psychological support. The control group received only the usual care provided in the outpatient clinic. Routine laboratory measures relevant to glycemic control (eg, fasting and postprandial blood glucose, HbA\u003Csub\u003E1c\u003C\/sub\u003E, and lipid profile) and body mass index (BMI) were assessed at baseline and after 3 months in all patients. Therapy was adjusted as needed. Patients in both groups were educated about blood glucose monitoring.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EMost (\u2265 95%) participants had type 2 diabetes with a mean duration of about 10 years. Patients treated at the day clinic had significantly higher fasting blood glucose and HbA\u003Csub\u003E1c\u003C\/sub\u003E levels at baseline (both \u003Cem\u003EP\u003C\/em\u003E \u0026lt; .001). Postprandial blood glucose levels (mean range, 12 \u2013 13 mmol\/L\u003Csup\u003E2\u003C\/sup\u003E) and BMI (\u223c 31 kg\/m\u003Csup\u003E2\u003C\/sup\u003E) were not significantly different.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAt the 3-month control visit, postprandial blood glucose (\u003Cem\u003EP\u003C\/em\u003E = .05), HbA\u003Csub\u003E1c\u003C\/sub\u003E (\u003Cem\u003EP\u003C\/em\u003E \u0026lt; .001), high-density lipoprotein (HDL) cholesterol (\u003Cem\u003EP\u003C\/em\u003E \u0026lt; .001), and BMI (\u003Cem\u003EP\u003C\/em\u003E = .003) levels were significantly improved in patients treated in the day clinic. There were no significant changes in the patients treated in the outpatient setting.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003ECompared with patients treated in the outpatient setting, patients seen at the day clinic had significantly lower fasting blood glucose levels (\u003Cem\u003EP\u003C\/em\u003E = .03) and a significantly more profound drop in HbA\u003Csub\u003E1c\u003C\/sub\u003E levels (\u003Cem\u003EP\u003C\/em\u003E\u0026lt;.001) at the 3-month control visit. \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E presents a comparison of all laboratory values for the 2 groups at 3 months.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/12028\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/12028\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12028\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EComparison of Laboratory Measurements at 3 Months\u003Csup\u003E\u003Csup\u003Ea\u003C\/sup\u003E\u003C\/sup\u003E\n            \u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-11\u0022\u003EThis study is limited by the fact that only short-term effects were assessed. Further research is needed to evaluate the long-term effects of structured diabetes education in achieving optimal glycemic control in adult patients.\u003C\/p\u003E\u003Cp id=\u0022p-12\u0022\u003ELike outpatient clinics, diabetes day clinics offer specific care for diabetic patients\u2014but the total time spent providing care to patients is more extensive, better structured, and focused on specific goals. Given that the pharmacologic intervention was the same for both groups in this study, it appears that the addition of a structured educational component provides added value to patients.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/32\/17.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzorq2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzorq2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}