Implementation of a systematic approach to diabetes in primary care in Bahia, Brazil improves metabolic outcomes

PRODIBA - Programa de Interiorização da Assistência ao Diabetes na Bahia (Project for Dissemination of Diabetes Care in the State of Bahia)

R. M. Chaves-Fonseca, O. S. Matos, Roberta A. Lordelo, M. Abreu, M. G. Farias, J. F. Coutinho, M. N. Ribeiro, L. Matteoni-Athayde, I. Lessa, J. Pousada, M. Oliveira, C. Lopes, E. Strock, R. Mazze

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Staged Diabetes Management (SDM) improves glycaemic control and reduces diabetes-related complications in primary care. Methods: An 18-month randomized controlled cohort study was conducted in two municipalities in the state of Bahia, Brazil, involving 100 patients with Type 2 diabetes in each municipality. In one municipality, healthcare professionals were trained to use SDM customized protocols for clinical decisions and, in the other municipality, no protocols for diabetes care were implemented. We hypothesized that, in the municipality with SDM trained professionals, patients would have better outcomes, including a fall in glycated haemoglobin (HbA1c). Results: Improvements in some metabolic parameters were observed in the SDM group, including a 22% decrease in mean random glucose, a significant 15% decrease in mean HbA1c, a 6% decrease in systolic blood pressure and an 11% decrease in diastolic blood pressure. There were no differences in body mass index and lipid profile. Conclusions: SDM customized algorithms are effective, practical and easy to use in primary healthcare teams with very limited resources. Diabet. Med. 26, 286-292 (2009).

Original languageEnglish (US)
Pages (from-to)286-292
Number of pages7
JournalDiabetic Medicine
Volume26
Issue number3
DOIs
StatePublished - Mar 1 2009

Fingerprint

Brazil
Primary Health Care
Blood Pressure
Patient Care Team
Glycosylated Hemoglobin A
Diabetes Complications
Clinical Protocols
Type 2 Diabetes Mellitus
Body Mass Index
Cohort Studies
Delivery of Health Care
Lipids
Glucose

Keywords

  • Brazil
  • Diabetes
  • Glycated haemoglobin
  • Primary care
  • Staged diabetes management

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Implementation of a systematic approach to diabetes in primary care in Bahia, Brazil improves metabolic outcomes : PRODIBA - Programa de Interiorização da Assistência ao Diabetes na Bahia (Project for Dissemination of Diabetes Care in the State of Bahia). / Chaves-Fonseca, R. M.; Matos, O. S.; Lordelo, Roberta A.; Abreu, M.; Farias, M. G.; Coutinho, J. F.; Ribeiro, M. N.; Matteoni-Athayde, L.; Lessa, I.; Pousada, J.; Oliveira, M.; Lopes, C.; Strock, E.; Mazze, R.

In: Diabetic Medicine, Vol. 26, No. 3, 01.03.2009, p. 286-292.

Research output: Contribution to journalArticle

Chaves-Fonseca, R. M. ; Matos, O. S. ; Lordelo, Roberta A. ; Abreu, M. ; Farias, M. G. ; Coutinho, J. F. ; Ribeiro, M. N. ; Matteoni-Athayde, L. ; Lessa, I. ; Pousada, J. ; Oliveira, M. ; Lopes, C. ; Strock, E. ; Mazze, R. / Implementation of a systematic approach to diabetes in primary care in Bahia, Brazil improves metabolic outcomes : PRODIBA - Programa de Interiorização da Assistência ao Diabetes na Bahia (Project for Dissemination of Diabetes Care in the State of Bahia). In: Diabetic Medicine. 2009 ; Vol. 26, No. 3. pp. 286-292.
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abstract = "Background: Staged Diabetes Management (SDM) improves glycaemic control and reduces diabetes-related complications in primary care. Methods: An 18-month randomized controlled cohort study was conducted in two municipalities in the state of Bahia, Brazil, involving 100 patients with Type 2 diabetes in each municipality. In one municipality, healthcare professionals were trained to use SDM customized protocols for clinical decisions and, in the other municipality, no protocols for diabetes care were implemented. We hypothesized that, in the municipality with SDM trained professionals, patients would have better outcomes, including a fall in glycated haemoglobin (HbA1c). Results: Improvements in some metabolic parameters were observed in the SDM group, including a 22{\%} decrease in mean random glucose, a significant 15{\%} decrease in mean HbA1c, a 6{\%} decrease in systolic blood pressure and an 11{\%} decrease in diastolic blood pressure. There were no differences in body mass index and lipid profile. Conclusions: SDM customized algorithms are effective, practical and easy to use in primary healthcare teams with very limited resources. Diabet. Med. 26, 286-292 (2009).",
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