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dc.contributor.authorLou, Qinglin
dc.contributor.authorYe, Qing
dc.contributor.authorWu, Haidi
dc.contributor.authorWang, Zhiyong
dc.contributor.authorWare, Robert S
dc.contributor.authorXiong, Yaqing
dc.contributor.authorXu, Fei
dc.date.accessioned2020-07-22T04:03:59Z
dc.date.available2020-07-22T04:03:59Z
dc.date.issued2020
dc.identifier.issn2052-4897
dc.identifier.doi10.1136/bmjdrc-2019-001030
dc.identifier.urihttp://hdl.handle.net/10072/395686
dc.description.abstractObjectives Highly efficient diabetes management programs are needed for tackling diabetes in China. This study aimed to assess the effectiveness of a clinic-based intensified diabetes management model (C-IDM) in Mainland China. Research design and methods A 2-year clinic-based randomized controlled trial was conducted among patients with type 2 diabetes in Nanjing, China. The C-IDM intervention components comprised four domains (disease targeting management, express referral channel, expert visit, patients' self-management) and an integrated running system (disease control centers, general hospitals and local clinics). Control group participants received their usual care, while intervention participants received both the C-IDM package and the usual services. The primary outcome variable was change of hemoglobin A1c (HbA1c). Mixed-effects models were used to compute effect estimates and 95% CI with consideration of both individual and cluster-level confounders. Results Overall, 1095 of 1143 participants were assessed at study completion. The mean change in HbA1c was significantly greater in the intervention group than in the control group (mean difference (MD)=-0.57, 95% CI-0.79 to-0.36). Similar results were observed for change in body mass index (MD=-0.29, 95% CI-0.49 to-0.10). Participants in the intervention group were more likely to achieve normal HbA1c and body weight compared with their counterparts in control group after adjusting for potentially confounding variables (adjusted OR=1.94, 95% CI 1.35 to 2.81 and 1.79, 95% CI 1.13 to 2.85, respectively). Conclusions The C-IDM model is feasible and effective in large-scale management of patients with type 2 diabetes in China. It has public health implications for tackling the burden of diabetes in China. Trial registration number ChiCTR-IOR-15006019.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherBMJ Publishing Group Ltd
dc.relation.ispartofpagefrome001030
dc.relation.ispartofissue1
dc.relation.ispartofjournalBMJ Open Diabetes Research & Care
dc.relation.ispartofvolume8
dc.subject.fieldofresearchMedical and Health Sciences
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchcode11
dc.subject.fieldofresearchcode1103
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsEndocrinology & Metabolism
dc.subject.keywordsclinic-based
dc.subject.keywordsdiabetes care
dc.titleEffectiveness of a clinic-based randomized controlled intervention for type 2 diabetes management: an innovative model of intensified diabetes management in Mainland China (C-IDM study)
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationLou, Q; Ye, Q; Wu, H; Wang, Z; Ware, RS; Xiong, Y; Xu, F, Effectiveness of a clinic-based randomized controlled intervention for type 2 diabetes management: an innovative model of intensified diabetes management in Mainland China (C-IDM study), BMJ Open Diabetes Research & Care, 2020, 8 (1), pp. e001030
dcterms.dateAccepted2019-12-18
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.date.updated2020-07-22T04:00:36Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© Author(s) (or their employer(s)) 2020. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
gro.hasfulltextFull Text
gro.griffith.authorWare, Robert


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