Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine III, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
Acta Diabetol. 2018 Apr;55(4):363-367. doi: 10.1007/s00592-018-1106-2. Epub 2018 Jan 30.
We analysed metabolic control, complications and satisfaction in people with and without DMP participation.
We retrospectively analysed the German data of the GUIDANCE study. The general practices included (n = 38) were selected from the physicians' register of the Thuringian Association of Statutory Health Insurance Physicians. Half of the practices (n = 19) participated in the DMP "Diabetes mellitus type 2".
Nine hundred and fifty-nine people were included in the analysis. Of these, 541 (56.4%) were enrolled in the DMP and 418 (43.6%) not. There was no difference between the two groups (DMP vs. no DMP) regarding age (67.8 vs. 67.6y), gender (female 50.6 vs. 52.2%), diabetes duration (9.8 vs. 9.5y), BMI (31.3 vs. 30.7 kg/m), HbA1c (7.2 vs. 7.2%), systolic blood pressure (139 vs. 140 mm Hg) or antihypertensive drug (89.5 vs. 88.8%). More DMP participants had regular screening of diabetic late complications: retinopathy 84.7 versus 69.9% (p < 0.001); polyneuropathy 93.0 versus 52.6% (p < 0.001). Chronic kidney disease was more frequent in DMP participants (15.0 vs. 9.3%, p = 0.005). Treatment satisfaction was higher in participants enrolled in the DMP (31.1 vs. 30.0; p = 0.002).
DMP participants do not exhibit positive selection. Process quality and treatment satisfaction are higher in DMP participants.
我们分析了参与和不参与 DMP 的患者的代谢控制、并发症和满意度。
我们回顾性分析了 GUIDANCE 研究的德国数据。纳入的普通诊所（n=38）选自图林根州法定健康保险医师协会的医生登记处。其中一半诊所（n=19）参与了 DMP“2 型糖尿病”。
共有 959 人纳入分析。其中，541 人（56.4%）参加了 DMP，418 人（43.6%）未参加。两组之间（DMP 与非 DMP）在年龄（67.8 与 67.6 岁）、性别（女性 50.6%与 52.2%）、糖尿病病程（9.8 与 9.5 年）、BMI（31.3 与 30.7 kg/m）、HbA1c（7.2 与 7.2%）、收缩压（139 与 140 mmHg）或抗高血压药物（89.5%与 88.8%）方面无差异。更多 DMP 参与者定期筛查糖尿病晚期并发症：视网膜病变 84.7%与 69.9%（p<0.001）；多发性神经病 93.0%与 52.6%（p<0.001）。DMP 参与者的慢性肾脏病更为常见（15.0%与 9.3%，p=0.005）。参加 DMP 的患者治疗满意度更高（31.1%与 30.0%；p=0.002）。
DMP 参与者没有表现出积极选择。DMP 参与者的过程质量和治疗满意度更高。
