Effect of lifestyle intervention for people with diabetes or prediabetes in real-world primary care: propensity score analysis

BMC Family Practice

Research Article

Mark G Spigt¹  Linda Deneer¹  Joris J Linmans¹  Luc G Gidding¹  J André Knottnerus¹  Annelies EM Lucas²  Marlies de Bakker²  Rik Linssen³ 

[1] CAPHRI, Department of General Practice, Maastricht University, P.O. Box 616, 6200, Maastricht, MD, The Netherlands;Corporation of Primary Health Care Centres Eindhoven, Eindhoven, The Netherlands;Political Science Department, Maastricht University, P.O. Box 616, 6200, Maastricht, MD, The Netherlands;

关键词: Propensity Score;    Usual Care;    Lifestyle Intervention;    Propensity Score Match;    Exercise Level;   

DOI  :  10.1186/1471-2296-12-95

 received in 2011-05-12, accepted in 2011-09-13,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundMany lifestyle interventions for patients with prediabetes or type 2 diabetes mellitus (T2DM) have been investigated in randomised clinical trial settings. However, the translation of these programmes into primary care seems challenging and the prevalence of T2DM is increasing. Therefore, there is an urgent need for lifestyle programmes, developed and shown to be effective in real-world primary care. We evaluated a lifestyle programme, commissioned by the Dutch government, for patients with prediabetes or type 2 diabetes in primary care.MethodsWe performed a retrospective comparative medical records analysis using propensity score matching. Patients with prediabetes or T2DM were selected from ten primary healthcare centres. Patients who received the lifestyle intervention (n = 186) were compared with a matched group of patients who received usual care (n = 2632). Data were extracted from the electronic primary care records. Propensity score matching was used to control for confounding by indication. Outcome measures were exercise level, BMI, HbA1c, fasting glucose, systolic and diastolic blood pressure, total cholesterol, HDL and LDL cholesterol and triglycerides and the follow-up period was one year.ResultsThere was no significant difference at follow-up in any outcome measure between either group. The reduction at one year follow-up of HbA1c and fasting glucose was positive in the intervention group compared with controls, although not statistically significant (-0.12%, P = 0.07 and -0.17 mmol/l, P = 0.08 respectively).ConclusionsThe effects of the lifestyle programme in real-world primary care for patients with prediabetes or T2DM were small and not statistically significant. The attention of governments for lifestyle interventions is important, but from the available literature and the results of this study, it must be concluded that improving lifestyle in real-world primary care is still challenging.

【 授权许可】

CC BY   
© Linmans et al; licensee BioMed Central Ltd. 2011