Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: The Microalbuminuria Education and Medication Optimisation (MEMO) study

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W. Crasto, J. Jarvis, K. Khunti, T. C. Skinner, L. J. Gray, J. Brela, J. Troughton, H. Daly, I. G. Lawrence, P. G. McNally, M. E. Carey, M. J. Davies

Aims: To determine whether tighter cardiovascular risk factor control with structured education in individuals with type 2 diabetes (T2DM) and microalbuminuria benefits cardiovascular risk factors. Methods: Participants from a multiethnic population, recruited from primary care and specialist clinics were randomised to intensive intervention with structured patient (DESMOND model) education (n= 94) or usual care by own health professional (n= 95). Primary outcome: change in HbA1c at 18. months. Secondary outcomes: changes in blood pressure (BP), cholesterol, albuminuria, proportion reaching risk factor targets, modelled cardiovascular risk scores. Results: Mean (SD) age and diabetes duration of participants were 61.5 (10.5) and 11.5 (9.3) years, respectively. At 18. months, intensive intervention showed significant improvements in HbA1c (7.1(1.0) vs. 7.8(1.4)%, p< 0.0001), systolic BP (129(16) vs. 139(17) mmHg, p< 0.0001), diastolic BP (70(11) vs. 76(12) mmHg, p< 0.001), total cholesterol (3.7(0.8) vs. 4.1(0.9) mmol/l, p= 0.001). Moderate and severe hypoglycaemia was 11.2 vs. 29.0%; p= 0.001 and 0 vs. 6.3%; p= 0.07, respectively. More intensive participants achieved ≥3 risk factor targets with greater reductions in cardiovascular risk scores. Conclusions: Intensive intervention showed greater improvements in metabolic control and cardiovascular risk profile with lower rates of moderate and severe hypoglycaemia. Intensive glycaemic interventions should be underpinned by structured education promoting self-management in T2DM.

Original languageEnglish
JournalDiabetes Research and Clinical Practice
Volume93
Issue number3
Pages (from-to)328-336
Number of pages9
ISSN0168-8227
DOIs
Publication statusPublished - 1 Sep 2011

    Research areas

  • Microalbuminuria, Structured education, Type 2 diabetes

ID: 189874198