Lifestyle Counseling in Routine Care and Long-Term Glucose, Blood Pressure, and Cholesterol Control in Patients With Diabetes

Introduction. Obesity and diabetes are difficult to treat in public clinics. We sought to determine the effectiveness of the Metabolic Rehabilitation Program (MRP) in achieving long-term weight loss and improving glycaemic control versus “best practice” diabetes clinic (DC) in obese patients using a retrospective cohort study.Methods. Patients with diabetes and BMI > 30 kg/m2who attended the MRP, which consisted of supervised exercise and intense allied health integration, or the DC were selected. Primary outcomes were improvements in weight and glycaemia with secondary outcomes of improvements in blood pressure and lipid profile at 12 and 30 months.Results. Baseline characteristics of both cohorts (40 MRP and 40 DC patients) were similar at baseline other than age (63 in MRP versus 68 years in DC,P=0.002). At 12 months, MRP patients lost 7.65 ± 1.74 kg versus 1.76 ± 2.60 kg in the DC group (P<0.0001) and 9.70 ± 2.13 kg versus 0.98 ± 2.65 kg at 30 months (P<0.0001). Similarly, MRP patients had significant absolute reductions in %HbA1c at 30 months versus the DC group (−0.86 ± 0.31% versus 0.12% ± 0.33%,P<0.038), with nonsignificant improvements in lipids and blood pressure in MRP patients.Conclusion. Further research is needed to establish the MRP as an effective strategy for achieving sustained weight loss and improving glycaemic control in obese patients with type 2 diabetes.

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Depression in Relation to Long-term Control of Glycemia, Blood Pressure, and Lipids in Patients with Diabetes

Journal of General Internal Medicine ◽

10.1007/s11606-010-1272-6 ◽

2010 ◽

Vol 25 (6) ◽

pp. 524-529 ◽

Cited By ~ 47

Author(s):

Susan R. Heckbert ◽

Carolyn M. Rutter ◽

Malia Oliver ◽

Lisa H. Williams ◽

Paul Ciechanowski ◽

...

Keyword(s):

Blood Pressure ◽

Patients With Diabetes

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Blood Pressure Variability and Risk for Progression of Cardiovascular and Renal Diseases in Patients with Diabetes Mellitus

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.1515/rjdnmd-2015-0036 ◽

2015 ◽

Vol 22 (3) ◽

pp. 297-304 ◽

Cited By ~ 1

Author(s):

Sorin Ioan Zaharie ◽

Teodora Daniela Maria ◽

Mirela Zaharie ◽

Maria Moţa ◽

Eugen Moţa

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Cardiovascular Events ◽

Target Organ Damage ◽

Organ Damage ◽

Renal Diseases ◽

Hypertensive Patients ◽

Patients With Diabetes ◽

Prognostic Importance

Abstract Accurate measurement of blood pressure (BP) and evaluation of global cardiovascular risk is crucial for diagnosis and treatment of hypertensive patients. When hypertension and diabetes mellitus are associated, the risk for cardiovascular events is bigger than the sum of the components. Beyond systolic and diastolic BP values as targets for antihypertensive treatment, recent guidelines recognize BP variability as an independent predictor for future cardiovascular events. 24 hours ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM) are two methods used in patient day to day life conditions for BP measurements. Increased variability of systolic and/or diastolic BP within one day (“short-term BP variability”) and also over longer periods (“long-term BP variability”) showed by ABPM and/or HBPM is associated with target-organ damage and cardiovascular events. This review is focused on the prognostic importance of BP variability in hypertensive patients with diabetes mellitus.

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A 1-Year Follow-Up Study on the Effect of Atenolol on Serum β2-Microglobulin Level in Hypertensive Diabetic Patients

Journal of International Medical Research ◽

10.1177/030006058901700208 ◽

1989 ◽

Vol 17 (2) ◽

pp. 162-167

Author(s):

H. Koh ◽

M. Waki ◽

S. Nambu

Keyword(s):

Blood Pressure ◽

Diabetic Patients ◽

Nitrogen Levels ◽

Renal Function Impairment ◽

Function Impairment ◽

Treatment Of Hypertension ◽

Patients With Diabetes ◽

Single Blind

Hypertensive diabetic patients are particularly prone to renal function impairment. A total of nine out-patients with diabetes and hypertension were, therefore, entered into this single-blind uncontrolled study on the effects of 50 mg/day atenolol on reducing blood pressure and preserving normal kidney functioning. Treatment and evaluations were continued for 12 months. Serum β2-microglobulin concentration was used as the index for measuring renal impairment. Atenolol significantly reduced heart rate, systolic and diastolic blood pressure, and serum β2-microglobulin concentrations compared with baseline. Plasma glucose and glycosylated haemoglobin levels were unchanged, and blood urea nitrogen levels were increased slightly (non-significant). Serum creatinine showed a tendency (non-significant) to reflect the changes in β2-microglobulin concentration. Ways in which atenolol may act to improve kidney functioning are suggested. It is concluded that atenolol is a favourable choice for the treatment of hypertension in diabetic patients with normally functioning kidneys since, even in long-term use, normal renal functioning is preserved.

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