Diabetes care and patient-oriented outcomes.

AMAJOR PROBLEM IN CONTEMPOrary diabetes mellitus care is the poor translation of knowledge derived from clinical research into routine clinical practice. To improve standards and outcomes of diabetes care, efforts in the followingareas appear crucial: diagnostic procedures and therapeutic management must be evidence-based; patients need to become more actively involved in their disease management; and every center/geographic area needs to perform quality assessment based on patient-oriented outcomes.

[1]  Philip D. Harvey,et al.  Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38 , 1998, BMJ.

[2]  D. Yellon,et al.  Sulfonylurea KATP blockade in type II diabetes and preconditioning in cardiovascular disease. Time for reconsideration. , 1996, Circulation.

[3]  Joël Ménard,et al.  Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial , 1998, The Lancet.

[4]  R. Schrier,et al.  The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. , 1998, The New England journal of medicine.

[5]  K. Malmberg Prospective randomised study of intensive insulin treatment on long term survival after acute myocardial infarction in patients with diabetes mellitus , 1997, BMJ.

[6]  B. Zinman,et al.  Exercise in Individuals With IDDM , 1994, Diabetes Care.

[7]  H. Parving Renoprotection in diabetes: genetic and non-genetic risk factors and treatment , 1998, Diabetologia.

[8]  Terje R Pedersen,et al.  Cholesterol Lowering With Simvastatin Improves Prognosis of Diabetic Patients With Coronary Heart Disease: A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S) , 1997, Diabetes Care.

[9]  W. Manning,et al.  Starting insulin therapy in patients with type 2 diabetes: effectiveness, complications, and resource utilization. , 1997, JAMA.

[10]  David M Nathan,et al.  Some answers, more controversy, from UKPDS , 1998, The Lancet.

[11]  S. Genuth,et al.  The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. , 1993, The New England journal of medicine.

[12]  C. Bulpitt,et al.  Effects of Calcium-Channel Blockade in Older Patients with Diabetes and Systolic Hypertension , 1999 .

[13]  B. Psaty,et al.  Treatment of hypertensive patients with diabetes , 1998, The Lancet.

[14]  I. Mühlhauser,et al.  EVALUATION OF A STRUCTURED TREATMENT AND TEACHING PROGRAMME ON NON-INSULIN-DEPENDENT DIABETES , 1988, The Lancet.

[15]  I. Mühlhauser,et al.  Implementation of Intensified Insulin Therapy: a European Perspective , 1995, Diabetic medicine : a journal of the British Diabetic Association.

[16]  R. Holman,et al.  Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) , 1998, The Lancet.

[17]  T. Chalmers,et al.  Meta-analysis of effects of intensive blood-glucose control on late complications of type I diabetes , 1993, The Lancet.

[18]  I. Mühlhauser,et al.  Diabetes education and insulin therapy: when will they ever learn? , 1993, Journal of internal medicine.

[19]  E. Kohner Diabetic Retinopathy , 1984, BMJ.

[20]  I. Mühlhauser,et al.  Social status and the quality of care for adult people with Type I (insulin-dependent) diabetes mellitus – a population-based study , 1998, Diabetologia.

[21]  I. Mühlhauser,et al.  Liberalized diet in patients with type 1 diabetes , 1995, Journal of internal medicine.

[22]  T R Pieber,et al.  Evaluation of a Structured Outpatient Group Education Program for Intensive Insulin Therapy , 1995, Diabetes Care.

[23]  L. Heinemann,et al.  Are presently available insulin analogues clinically beneficial? , 1997, Diabetologia.

[24]  Preventive Foot Care in People with Diabetes , 2000 .

[25]  R. Holman,et al.  Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. , 1998 .

[26]  L. Vignati,et al.  Health-Related Quality-of-Life Results From Multinational Clinical Trials of Insulin Lispro: Assessing benefits of a new diabetes therapy , 1997, Diabetes Care.

[27]  I. Mühlhauser,et al.  Intensified antihypertensive therapy is associated with improved survival in type 1 diabetic patients with nephropathy , 1995, Journal of hypertension.

[28]  I. Mühlhauser,et al.  Intensified insulin therapy and the risk of severe hypoglycaemia , 1997, Diabetologia.

[29]  I. Mühlhauser,et al.  Intensified treatment and education of type 1 diabetes as clinical routine. A nationwide quality-circle experience in Germany. ASD (the Working Group on Structured Diabetes Therapy of the German Diabetes Association). , 1999, Diabetes care.

[30]  V. Koivisto,et al.  Meta-Analysis of the Effect of Insulin Lispro on Severe Hypoglycemia in Patients With Type 1 Diabetes , 1998, Diabetes Care.