![]() Performance of the model was assessed using baseline and 4- and 10-year follow-up data from the older-onset diabetic popu-lation studied in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). Monte Carlo techniques were used to implement a semi-Markov model. Direct medical costs were derived for managed care patients with type 2 diabetes using paid insurance claims. Health utility scores were derived for patients with type 2 diabetes using the Quality of Well Being–Self-Administered. RESEARCH DESIGN AND METHODS - The incidence of type 2 diabetes and its complications and comorbidities were derived from population-based epidemiologic studies and randomized, controlled clinical trials. OBJECTIVE - To develop and validate a comprehensive computer simulation model to assess the impact of screening, prevention, and treatment strategies on type 2 diabetes and its complications, comorbidities, quality of life, and cost. Diabetes Care 31:795–797, 2008 S everal risk models are available forpeople with diabetes (1–3) based onclinical risk factors such as systolic blood pressure and A1C. CONCLUSIONS - Self-rated health profiles compiled using the EQ VAS provide valuable information on patient risk in addition to that determined from clinical risk factors alone. RESULTS - A 10-point higher EQ VAS score was associated with a 6 % (95 % CI 1–11) lower risk of vascular events and a 22 % (95 % CI 15–28) lower risk of diabetesc complications. We used Cox propor-tional hazards modeling to estimate hazard ratios associated with EQ VAS scores after controlling for baseline covariates: age, sex, smoking status, diabetes duration, A1C, systolic blood pressure, BMI, plasma lipids, and prior clinical history. RESEARCHDESIGNANDMETHODS - The study is based on 7,348 individuals with a mean follow-up of 2.4 years after completing the EQ-5D questionnaire. OBJECTIVE - To investigate whether self-rated health profiles compiled using the EuroQol group’s visual analog scale (EQ VAS) are independent predictors of vascular events and major complications in people with type 2 diabetes after controlling for standard clinical risk factors. Diabetes Care 32:81–83, 2009 Improving the quality of diabetes carehas been a major focus of the Norwe-gian College of General Practice since CONCLUSIONS - There have been substantial improvements in type 2 diabetes primary care in Norway that are potentially related to major improvements in health outcomes. ![]() The 10-year risk of coronary heart disease for an average male patient declined from 42 to 29%. ![]() Mean A1C declined from 7.74 to 7.15%, systolic blood pressure from 150.0 to 140.4 mmHg, and cholesterol from 6.28 to 5.0 mmol/l (P 0.001, age and sex adjusted). RESULTS - Between 19, there were significant improvements in the proportion of patients for whom important laboratory analyses, smoking habits, height, weight, and referral to eye examination were recorded. ![]() RESEARCH DESIGNANDMETHODS - Two cross-sectional surveys were examined that identified all patients (n 1,470 in 1995 and n 2,699 in 2005) with type 2 diabetes attending 33 general practices in 19. OBJECTIVE - To assess changes in the quality of care in Norway for patients with type 2 diabetes. ![]() The correlation of inflammatory disease activity with metabolic syndrome provides additional evidence for a link between inflammation and metabolic disturbances/vascular morbidity. These studies have documented a high prevalence of metabolic syndrome which correlates with disease activity and markers of atherosclerosis. The presence of inflammatory cytokines together with the well-documented increased risk for cardiovascular diseases in patients with inflammatory arthritides and systemic lupus erythematosus has prompted studies to examine the prevalence of the metabolic syndrome in an effort to identify subjects at risk in addition to that conferred by traditional cardiovascular risk factors. In these subjects, abdominal adipose tissue is a source of inflammatory cytokines such as tumor necrosis factor-alpha, known to promote insulin resistance. Subjects with metabolic syndrome-a constellation of cardiovascular risk factors of which central obesity and insulin resistance are the most characteristic-are at increased risk for developing diabetes mellitus and cardiovascular disease. ![]()
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