Impact of intervention on metabolic outcomes among dropouts with type 2 diabetes

• Published in: Advances in medical sciences 2018-03, Vol.63 (1), p.5-8
• Main Authors: Laine, Merja K., Kauppila, Timo, Honkasalo, Mikko, Raina, Marko, Eriksson, Johan G.
• Format: Article
• Language: English
• Subjects: Blood Pressure; Body Mass Index; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - physiopathology; Dropout; Female; Glycated Hemoglobin A - metabolism; Humans; Lipids - blood; Male; Metabolic profile; Middle Aged; Patient Dropouts; Primary health care; Type 2 diabetes
• ISSN: 1896-1126; 1898-4002
• DOI: 10.1016/j.advms.2017.05.003

The aim of this study was to evaluate the effect of an individual intervention given by health care professionals to dropouts with type 2 diabetes (T2D) on their metabolic profile. In 2010, we identified 356 T2D dropouts in Vantaa Health Centre, Finland. At the baseline visit the participants’ status was assessed including laboratory tests. Diabetes counseling was given, and drug treatment was enhanced when needed. The follow-up visit was performed 13 to 30 months later including the same assessments as performed at the baseline visit. The dropouts who attended the follow-up visit formed the study group. One third (n=115) of the dropouts participated in the follow-up visit. The study participants (mean age 61.4 years) were older than the non-participants (mean age 58.5 years) (p=0.009). After the intervention the proportion of participants with hemoglobin A1c≥9% (75mmol/mol) decreased from 15.5% to 5.2% (p=0.004). Improvements were also observed in general in hemoglobin A1c, from 6.6% (49mmol/mol) to 6.3% (45mmol/mol) (p=0.001), in total cholesterol, from 4.9mmol/l to 4.5mmol/l (p=0.011), in low-density lipoprotein cholesterol, from 2.9mmol/l to 2.6mmol/l (p=0.015) and in diastolic blood pressure, from 90mmHg to 84mmHg (p=0.001). Dropouts with T2D were difficult to bring back to the public health care system, especially men under the age of 60 years. Dropouts who participated in the intervention showed improvements in several metabolic outcomes.