Results of the pilot study of DIADEM—A comprehensive disease management programme for type 2 diabetes

Luzio, S.; Piehlmeier, W.; Tovar, C.; Eberl, S.; Lätzsch, G.; Fallböhmer, E.; Rumpel, E.; Owens, D.R.; Landgraf, R.

doi:10.1016/j.diabres.2006.09.025

« Previous Next »Diabetes Research and Clinical Practice
Volume 76, Issue 3 , Pages 410-417, June 2007

Results of the pilot study of DIADEM—A comprehensive disease management programme for type 2 diabetes

S. Luzio
- University of Wales College of Medicine, Cardiff, UK
- Corresponding author at: Diabetes Research Unit, Llandough Hospital, Penlan Road, Penarth, Cardiff, UK. Tel.: +44 2920 716 921; fax: +44 2920 350 147.
W. Piehlmeier
- Diabetes Centre “Innenstadt”, University of Munich, Germany
C. Tovar
- Diabetes Centre “Innenstadt”, University of Munich, Germany
S. Eberl
- Diabetes Centre “Innenstadt”, University of Munich, Germany
G. Lätzsch
- Luisenhospital, Aachen, Germany
E. Fallböhmer
- Luisenhospital, Aachen, Germany
E. Rumpel
- Siemens AG, Erlangen, Germany
D.R. Owens
- University of Wales College of Medicine, Cardiff, UK
R. Landgraf
- Diabetes Centre “Innenstadt”, University of Munich, Germany

Received 31 July 2006; accepted 19 September 2006. published online 07 November 2006.

Abstract

Aims

The purpose of the study was to evaluate the feasibility and preliminary clinical effects of the DIADEM disease management programme for type 2 diabetic patients.

Methods

The study was performed at two test sites (Cardiff, UK: Aachen, Germany) including 137 and 166 patients, respectively. In 16 study centres any patients with type 2 diabetes capable of communicating by phone and able to perform blood pressure, blood glucose or urine glucose self-measurements were included. The maximum programme duration was 6 months at Cardiff and 4 months at Aachen, during which patients were assessed for glycaemic control, cardiovascular risk profile and the presence of complications of diabetes. Data were entered via the internet to a central server.

Results

At entry into the programme the patient group in Cardiff had significantly lower mean age (60.3±9.4 years versus 64.9±8.7 years, p<0.001) and duration of diabetes (6.1±5.7 years versus 7.4±7.0 years, p<0.05) than in Aachen, however body mass index (31.6±5.2kg/m² versus 29.5±4.9kg/m², p<0.01), HbA1c (7.7±1.2% versus 7.1±1.2%, p<0.001) and systolic blood pressure (138.4±15.1mmHg versus 133.5±11.5mmHg, p<0.001) were significantly higher. In contrast, total cholesterol (4.7±1.0mmol/l versus 5.5±1.1mmol/l, p<0.001) was significantly lower in Cardiff compared to Aachen. Following entry into the programme highly significant improvements in HbA1c (Cardiff from 7.7% to 7.1%, p<0.001; Aachen from 7.2% to 6.8%, p<0.05) and total cholesterol concentrations (Cardiff: 4.66–4.46mmol/l; Aachen: 5.33–5.15mmol/l; both p<0.05) were observed. There were no significant changes in blood pressure at either site.

Conclusions

Intensive diabetes care was delivered to DIADEM patients and relevant and significant improvements in diabetes care were achieved demonstrating that an IT-based diabetes disease management service can improve care for patients with type 2 diabetes.

Keywords: Diabetes, Disease management programmes (DMP), Integrated care, Telemedicine