Integrated personalized diabetes management improves glycemic control in patients with insulin-treated type 2 diabetes: Results of the PDM-ProValue study program. (October 2018)

• Record Type: Journal Article
• Authors: Kulzer, Bernhard; Daenschel, Wilfried; Daenschel, Ingrid; Schramm, Wendelin; Messinger, Diethelm; Weissmann, Joerg; Vesper, Iris; Parkin, Christopher G.; Heinemann, Lutz
• Is Part Of: Diabetes research and clinical practice. Volume 144(2018)
• Page Start: 200
• Page End: 212
• Publication Date: 2018-10
• Subjects: AEs adverse events -- BG blood glucose -- CNL control -- DSP diabetes specialist practitioner -- DT-PSQ Diabetes Treatment-Physician Satisfaction Questionnaire -- DTSQc Diabetes Treatment Satisfaction Questionnaire (change) -- DTSQs Diabetes Treatment Satisfaction Questionnaire (status) -- GCP Good Clinical Practice -- GEE Generalized Estimating Equations -- GKV Gesetzliche Krankenversicherung -- GP general practitioner -- HbA1c glycosylated hemoglobin -- iPDM integrated personalized diabetes management -- PDM personalized diabetes management -- PRO patient-reported outcomes -- PwD patients with diabetes -- SD standard deviation -- SMBG self-monitoring of blood glucose; Diabetes management -- SMBG -- Type 2 diabetes -- Personalized diabetes therapy -- Digital tools -- Clinical inertia; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2018.09.002
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: Globally, many patients with insulin-treated type-2 diabetes are suboptimally controlled. The PDM-ProValue study program evaluated whether integrated personalized diabetes management (iPDM) has the potential to improve clinical outcomes. Methods: 101 practices with 907 patients participated in the 12-month, prospective, controlled, cluster-randomized study program. HbA1c levels, therapy changes, frequency of hypoglycemic episodes, patient reported outcomes, and physician satisfaction were assessed. Results: iPDM led to a greater reduction in HbA1c after 12 months vs. usual care (−0.5%, p < 0.0001 vs. −0.3%, p < 0.0001), (Diff. 0.2%, p = 0.0324). Most of the HbA1c reduction occurred after 3 months and remained stable thereafter. The percentage of patients with therapy adjustments was higher in the iPDM group at all visits (p < 0.01 at week 3, month 3, month 6). Patient adherence at month 12 was higher in the iPDM group compared to baseline (Odds ratio = 2.39; p = 0.0003); also, patient treatment satisfaction (DTSQc: 12.2 vs. 10.4, δ = 1.78, p = 0.004; DTSQs: 31.0 vs. 30.0, δ = 0.924, p = 0.02), and physician satisfaction was higher in the intervention group. Conclusions: iPDM improved the use of diagnostic data leading to better glycemic control, more timely treatment adjustments (indicating reduced clinical inertia), and increased patient adherence and treatment satisfaction among patients and physicians.