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Structured diabetes therapy and education improves the outcome of patients with insulin treated diabetes mellitus. The 10 year follow-up of a prospective, population-based survey on the quality of diabetes care (the JEVIN Trial).
Exp Clin Endocrinol Diabetes. 2006 Jan; 114(1):18-27.EC

Abstract

AIMS/HYPOTHESIS

JEVIN (Jena's St. Vincent Trial) is a prospective, 10 year follow-up, population-based survey of all insulin treated patients with type 1 and type 2 diabetes mellitus aged 16 to 60 years and living in the city of Jena (100,000 inhabitants), Thuringia, Germany. It aims to show the effects of implementation of the St. Vincent Declaration and to evaluate the effect of recent changes in the health care system and new treatment strategies.

PATIENTS AND METHODS

190 patients (83% of the target population), 244 patients (90%) and 261 patients (90%) were studied in 1989/90, 1994/95 and 1999/2000, respectively.

RESULTS

Up to 1994/95, the HbA1c of patients with type 1 diabetes mellitus increased (1994/95: 8.50+/-1.80% versus 1989/90: 7.83+/-1.60%, p=0.002). For patients with type 2 diabetes mellitus, it remained constant (9.01+/-2.06% versus 9.17+/-1.60%, n. s.). During the period from 1994/95 to 1999/2000, there was a substantial improvement in the relative HbA1c of both, patients with type 1 (7.62+/-1.55%, p<0.0001), and with type 2 diabetes (7.57+/-1.29%, p<0.0001). Up to 1999/2000, 87.7% of the patients with type 1 (1989/90: 0%, 1994/95: 73.2%) and 96.6% of the patients with type 2 diabetes (1989/90: 0%, 1994/95: 89.7%) participated in TTP's. The incidence of acute and the prevalence of long-term complications remained constant.

CONCLUSIONS

Results of the population-based, prospective trial to optimise patients' quality of diabetic control suggest: For patients with insulin treated type 2 diabetes mellitus, excellent treatment can be available by primary care physicians interested, educated and highly engaged in diabetes therapy. Moreover, structured diabetes therapy consisting of treatment and teaching programmes, regular self-monitoring, patients' insulin dose adjustment and patients' empowerment, should be offered to all patients with diabetes mellitus.

Authors+Show Affiliations

Department of Internal Medicine III, University of Jena Medical School, Jena, Germany. inselklinik.schiel@medigreif.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16450312

Citation

Schiel, R, et al. "Structured Diabetes Therapy and Education Improves the Outcome of Patients With Insulin Treated Diabetes Mellitus. the 10 Year Follow-up of a Prospective, Population-based Survey On the Quality of Diabetes Care (the JEVIN Trial)." Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association, vol. 114, no. 1, 2006, pp. 18-27.
Schiel R, Voigt U, Ross IS, et al. Structured diabetes therapy and education improves the outcome of patients with insulin treated diabetes mellitus. The 10 year follow-up of a prospective, population-based survey on the quality of diabetes care (the JEVIN Trial). Exp Clin Endocrinol Diabetes. 2006;114(1):18-27.
Schiel, R., Voigt, U., Ross, I. S., Braun, A., Rillig, A., Hunger-Dathe, W., Stein, G., & Müller, U. A. (2006). Structured diabetes therapy and education improves the outcome of patients with insulin treated diabetes mellitus. The 10 year follow-up of a prospective, population-based survey on the quality of diabetes care (the JEVIN Trial). Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association, 114(1), 18-27.
Schiel R, et al. Structured Diabetes Therapy and Education Improves the Outcome of Patients With Insulin Treated Diabetes Mellitus. the 10 Year Follow-up of a Prospective, Population-based Survey On the Quality of Diabetes Care (the JEVIN Trial). Exp Clin Endocrinol Diabetes. 2006;114(1):18-27. PubMed PMID: 16450312.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Structured diabetes therapy and education improves the outcome of patients with insulin treated diabetes mellitus. The 10 year follow-up of a prospective, population-based survey on the quality of diabetes care (the JEVIN Trial). AU - Schiel,R, AU - Voigt,U, AU - Ross,I S, AU - Braun,A, AU - Rillig,A, AU - Hunger-Dathe,W, AU - Stein,G, AU - Müller,U A, PY - 2006/2/2/pubmed PY - 2006/5/4/medline PY - 2006/2/2/entrez SP - 18 EP - 27 JF - Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association JO - Exp Clin Endocrinol Diabetes VL - 114 IS - 1 N2 - AIMS/HYPOTHESIS: JEVIN (Jena's St. Vincent Trial) is a prospective, 10 year follow-up, population-based survey of all insulin treated patients with type 1 and type 2 diabetes mellitus aged 16 to 60 years and living in the city of Jena (100,000 inhabitants), Thuringia, Germany. It aims to show the effects of implementation of the St. Vincent Declaration and to evaluate the effect of recent changes in the health care system and new treatment strategies. PATIENTS AND METHODS: 190 patients (83% of the target population), 244 patients (90%) and 261 patients (90%) were studied in 1989/90, 1994/95 and 1999/2000, respectively. RESULTS: Up to 1994/95, the HbA1c of patients with type 1 diabetes mellitus increased (1994/95: 8.50+/-1.80% versus 1989/90: 7.83+/-1.60%, p=0.002). For patients with type 2 diabetes mellitus, it remained constant (9.01+/-2.06% versus 9.17+/-1.60%, n. s.). During the period from 1994/95 to 1999/2000, there was a substantial improvement in the relative HbA1c of both, patients with type 1 (7.62+/-1.55%, p<0.0001), and with type 2 diabetes (7.57+/-1.29%, p<0.0001). Up to 1999/2000, 87.7% of the patients with type 1 (1989/90: 0%, 1994/95: 73.2%) and 96.6% of the patients with type 2 diabetes (1989/90: 0%, 1994/95: 89.7%) participated in TTP's. The incidence of acute and the prevalence of long-term complications remained constant. CONCLUSIONS: Results of the population-based, prospective trial to optimise patients' quality of diabetic control suggest: For patients with insulin treated type 2 diabetes mellitus, excellent treatment can be available by primary care physicians interested, educated and highly engaged in diabetes therapy. Moreover, structured diabetes therapy consisting of treatment and teaching programmes, regular self-monitoring, patients' insulin dose adjustment and patients' empowerment, should be offered to all patients with diabetes mellitus. SN - 0947-7349 UR - https://www.unboundmedicine.com/medline/citation/16450312/Structured_diabetes_therapy_and_education_improves_the_outcome_of_patients_with_insulin_treated_diabetes_mellitus__The_10_year_follow_up_of_a_prospective_population_based_survey_on_the_quality_of_diabetes_care__the_JEVIN_Trial__ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2005-873079 DB - PRIME DP - Unbound Medicine ER -