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• W4245676852 abstract "The Future of NIDDM Care1 January 1996Where Do We Go from Here?Charles M. Clark Jr., MDCharles M. Clark Jr., MDFrom the Regenstrief Health Center, Richard L. Roudebush Veterans Affairs Medical Center, and the Indiana University School of Medicine, Indianapolis, Indiana.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-1_Part_2-199601011-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Moving from research findings to clinical practice is a complex process involving the quality of the data; the readiness of the health care system to accept, implement, and pay for the changes recommended by the findings; and the diffusion of the technology and expertise necessary for implementation. Conference participants believe that the data reported here and by others represent an urgent call to recognize that non–insulin-dependent diabetes mellitus (NIDDM) is a serious disease with costly morbidity and mortality, which can be reduced by a comprehensive therapeutic approach. This approach, outlined in Table 3 of this supplement's introduction (see “Introduction: Risks ...References 1. Shea S, Gemson DH, Mossel P. Management of high blood cholesterol by primary care physicians: diffusion of the National Cholesterol Education Program Adult Treatment Panel guidelines. J Gen Intern Med. 1990;5:327-34. CrossrefMedlineGoogle Scholar 2. Clement S. Diabetes self-management education. Diabetes Care. 1995;18:1204-14. CrossrefMedlineGoogle Scholar 3. Anderson RM, Funnell MM, Butler PM, Arnold MS, Fitzgerald JT, Feste CC. Patient empowerment. Diabetes Care. 1995;18:943-9. CrossrefMedlineGoogle Scholar 4. Anderson LA, Jenkins CM. Educational innovations in diabetes: where are we now? Diabetes Spectrum. 1994;7:90-128. Google Scholar 5. Glasgow RE. A practical model of diabetes management and education. Diabetes Care. 1995;18:117-26. CrossrefMedlineGoogle Scholar 6. Korhonen T, Huttunen JK, Aro A, Hentinen M, Ihalainen O, Majander H, et al . A controlled trial on the effects of patient education in the treatment of insulin-dependent diabetes. Diabetes Care. 1983;6:256-61. CrossrefMedlineGoogle Scholar 7. Coonrod BA, Betschart J, Harris MI. Frequency and determinants of diabetes patient education among adults in the U.S. population. Diabetes Care. 1994;17:852-8. CrossrefMedlineGoogle Scholar 8. Gruesser M, Bott U, Ellermann P, Kronsbein P, Joergens V. Evaluation of a structured treatment and teaching program for non-insulin-treated type II diabetic outpatients in Germany after the nationwide introduction of reimbursement policy for physicians. Diabetes Care. 1993;16:1268-75. CrossrefMedlineGoogle Scholar 9. American Diabetes Association. Physician's Guide to Non-Insulin-Dependent (Type II) Diabetes: Diagnosis and Treatment. Alexandria, Virginia: American Diabetes Association; 1988. Google Scholar 10. McNeely MJ, Boyko EJ, Ahroni JH, Stensel VL, Reiber GE, Smith DG, et al . The independent contributions of diabetic neuropathy and vasculopathy in foot ulceration. Diabetes Care. 1995;2:216-9. CrossrefGoogle Scholar 11. Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993;16:434-44. CrossrefMedlineGoogle Scholar 12. Working Group on Hypertension in Diabetes. Statement on hypertension in diabetes mellitus. Final report. Arch Intern Med. 1987;147:830-42. CrossrefMedlineGoogle Scholar 13. Garg A, Grundy SM. Management of dyslipidemia in NIDDM. Diabetes Care. 1990;13:153-69. CrossrefMedlineGoogle Scholar 14. Dunn FL. Management of hyperlipidemia in diabetes mellitus. Endocrinol Metab Clin North Am. 1992;21:395-414. CrossrefMedlineGoogle Scholar 15. Steering Committee of the Physicians' Health Study Research Group. Findings from the aspirin component of the ongoing Physicians' Health Study. N Engl J Med. 1988;318:262-4. CrossrefMedlineGoogle Scholar 16. The Diabetes Control and Complications Trial Research Group. The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the Diabetes Control and Complications Trial Diabetes. 1995;44:968-83. Google Scholar 17. Genuth S. Insulin use in NIDDM. Diabetes Care. 1990;13:1240-64. CrossrefMedlineGoogle Scholar 18. Hermann LS, Melander A. Biguanides: basic aspects and clinical uses. In: Alberti KG, ed. International Textbook of Diabetes Mellitus. New York: John Wiley & Sons; 1992:773-95. Google Scholar 19. Chiasson JL, Josse RG, Hunt JA, Palmason C, Rodger NW, Ross SA, et al . The efficacy of acarbose in the treatment of patients with non–insulin-dependent diabetes mellitus. A multicenter controlled clinical trial. Ann Intern Med. 1994;121:928-35. LinkGoogle Scholar 20. Nolan JJ, Ludvik B, Beerdsen P, Joyce M, Olefsky J. Improvement in glucose tolerance and insulin resistance in obese subjects treated with troglitazone. N Engl J Med. 1994;331:1188-93. CrossrefMedlineGoogle Scholar 21. Mimura K, Umeda F, Hiramatsu S, Taniguchi S, Ono Y, Nakashima N, et al . Effects of a new oral hypoglycaemic agent (CS-045) on metabolic abnormalities and insulin resistance in type 2 diabetes. Diabetic Med. 1994;11:685-91. CrossrefMedlineGoogle Scholar 22. Ohkubo Y, Kishikawa H, Araki E, Miyata T, Isami S, Motoyoshi S, et al . Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non–insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Research and Clinical Practice. 1995;28:103-17. CrossrefMedlineGoogle Scholar 23. Hiss RG, Davis WK. Intensified glycemic control and changes in training and continuing education of physicians. Diabetes Reviews. 1994;2:310-21. Google Scholar 24. Funnell MM. Role of nurses in the implementation of intensified management. Diabetes Reviews. 1994;2:322-30. Google Scholar 25. Brackenridge BP. The role of the dietitian in intensified therapy. Diabetes Reviews. 1994;2:331-7. Google Scholar 26. National Diabetes Data Group (U.S.). Diabetes in America. Second ed. Bethesda, Maryland: U.S. Department of Health and Human Services; 1995. NIH publication no. 95-1468. Google Scholar Author, Article, and Disclosure InformationAuthors: Charles M. Clark Jr., MDAffiliations: From the Regenstrief Health Center, Richard L. Roudebush Veterans Affairs Medical Center, and the Indiana University School of Medicine, Indianapolis, Indiana.Note: This article is one of a series of articles comprising an Annals of Internal Medicine supplement entitled “Risks and Benefits of Intensive Management in Non-Insulin-dependent Diabetes Mellitus: The Fifth Regenstrief Conference.” To view a complete list of the articles included in this supplement, please view its Table of Contents. Previousarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byImpact of state mandatory insurance coverage on the use of diabetes preventive carePreventing diabetes complications: Living up to the promise 1 January 1996Volume 124, Issue 1_Part_2Page: 184-186KeywordsCardiovascular diseasesClinical trialsHealth careHemoglobinHyperlipidemiaHypertensionInsulinMedical risk factorsNeuropathyType 2 diabetes ePublished: 15 August 2000 Issue Published: 1 January 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ..." @default.
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