Diabetes Treatment Options Expanded

Scientists have developed and tested a tool to involve patients more in their diabetes treatment and medication choices.

Victor Montori, M.D., a Mayo Clinic endocrinologist in Rochester, co-author of the study, said that the tool, a set of decision aid cards, could help diabetics make decisions involving their disease and perhaps lead to better outcomes.

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A randomised trial was conducted at 11 primary care and family medicine sites within Mayo Health System and Olmsted Medical Center, all in southeast Minnesota.

Twenty-one clinicians and eighty-five patients participated in the trial with thirty-seven patients receiving "usual care" and forty-eight patients using the decision aid cards.

Health care clinicians, consisting of physicians, physician assistants and nurse practitioners, were responsible for managing diabetes in adult patients with medication options.

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The Diabetes Medication Choice decision aid cards were used to help patients and their clinician reach a decision regarding their course of care.

The cards were created by an innovative team of patients, clinicians, educators and designers. The tool consists of six cards that describe the possible effects of various medication choices on six outcomes: weight change, low blood sugar, blood sugar, daily routine, daily sugar testing and side effects.

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Clinicians were randomised to either use the decision aid cards (intervention) or discuss medications as usually done (control). Data was gathered from a self-administered written survey completed by patients immediately after the patient's visit.

Compared with the control patients, those who used the cards found them helpful and felt they were more involved in making decisions about their diabetes medication.

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Both groups had near-perfect adherence to their medication use, the cards were effective in involving patients with type 2 diabetes in the decision-making.

The results of this randomized trial have been published in September's issue of Archives of Internal Medicine.

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