Primary care diabetes最新文献

{"title":"Early diabetes education and long-term cardiovascular outcomes among adults with newly diagnosed Type 2 diabetes.","authors":"Deborah A Cohen, Claudia Nau, Seungyong Han, Mina Habib, Roland Sturm, John Martin, Kristi Reynolds, Haoyuan Zhong, Erika Estrada, Xia Li, David Yi, Bing Han","doi":"10.1016/j.pcd.2026.10.001","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.10.001","url":null,"abstract":"<p><strong>Aims: </strong>To assess whether early diabetes education after incident type 2 diabetes diagnosis was associated with lower long-term risk of myocardial infarction, heart failure, and stroke.</p><p><strong>Methods: </strong>We analyzed electronic health records (EHR) for 134,411 patients diagnosed with type 2 diabetes (T2DM) from 2008 to 2019, comparing those who never enrolled in any diabetes education classes or were not involved in individual counseling to those who attended classes within the 3 months of their initial diagnosis. Using Cox proportional hazards models, we estimated hazard ratios (HR) for myocardial infarction (MI), heart failure (HF), and stroke over a 12-year follow-up period.</p><p><strong>Results: </strong>Compared to patients who never took any diabetes education classes, those who enrolled were at lower risk of MI [HR: 0.77 (95% CI 0.69, 0.87), HF [HR: 0.84 (95% CI 0.75, 0.94)] and stroke (HR: 0.84 (95% CI 0.75, 0.93)] after adjustment for demographic and clinical risk factors.</p><p><strong>Conclusions: </strong>Early diabetes education was associated with lower long-term cardiovascular risk among adults with newly diagnosed type 2 diabetes. These findings support timely referral to structured diabetes self-management education in primary care.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superimposed entrapment neuropathy in diabetes: Evidence review and algorithm for referral decisions.","authors":"Andrew Rader, D Scott Nickerson, Logan Orr, Aaron Ruter","doi":"10.1016/j.pcd.2026.09.006","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.09.006","url":null,"abstract":"<p><p>Diabetic peripheral neuropathy (DPN) is common, disabling, and associated with substantial risk of foot ulceration and lower extremity complications. A subset of patients develops superimposed peripheral nerve entrapment, which can exacerbate pain, impair protective sensation, and contribute to microcirculatory dysfunction. Although surgical decompression has been studied for more than three decades, awareness of entrapment features remains low in primary care, and guidance on patient selection is limited. This review summarizes current evidence on the clinical identification of focal nerve compression in patients with DPN and evaluates outcomes of decompression in appropriately selected patients. Across randomized controlled trials and observational studies, decompression is associated with reductions in neuropathic pain, improvements in selected sensory measures, and lower recurrence of neuropathic foot ulcers in patients who exhibit clinical features of entrapment. Based on this evidence, we propose a structured clinical algorithm to support primary care clinicians in identifying potential candidates for surgical evaluation. The algorithm emphasizes confirmation of DPN, screening for characteristic entrapment findings, assessment of prognostic indicators, optimization of conservative care, and appropriate referral. This approach aims to improve recognition of superimposed compression neuropathy and to provide practical guidance for evaluation and referral within primary care settings.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-level clinical inertia in chronic kidney disease management in primary care: A retrospective cross-sectional analysis of coding, reclassification and risk stratification.","authors":"A Zafar, C Scarlata, A Saeed, M Chishti, N Jaleel","doi":"10.1016/j.pcd.2026.09.004","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.09.004","url":null,"abstract":"<p><strong>Aims/hypothesis: </strong>Accurate coding, longitudinal stage review and complete risk stratification underpin chronic kidney disease (CKD) care in primary care, especially in people with diabetes, where CKD modifies cardiovascular risk, prescribing safety and referral thresholds. We hypothesised that, beyond well-described inertia in pharmacological treatment intensification, primary care records would also exhibit inertia in diagnostic coding, longitudinal reclassification and albuminuria-based risk stratification, clustering with higher kidney and cardiovascular risk.</p><p><strong>Methods: </strong>We performed a retrospective cross-sectional analysis of adult primary care records with coded CKD. The latest estimated glomerular filtration rate (eGFR) was compared with the coded stage. Where eGFR suggested reclassification but coding was unchanged, manual case review determined whether changes were sustained for ≥ 3 months. Risk was derived from the latest urine albumin-to-creatinine ratio (uACR) using KDIGO categories. Modifiable risk factors were predefined as blood pressure above CKD-specific thresholds and/or HbA1c ≥ 58 mmol/mol. A separate electronic search identified adults with uncoded CKD.</p><p><strong>Results: </strong>Of 583 individuals with coded CKD, 581 were analysed. Among those with unchanged coding despite eGFR suggesting de-escalation, 47/87 (54.0%) had sustained improvement; of 47 with unchanged coding despite a latest eGFR suggesting escalation, 26 (55.3%) had sustained decline. uACR was missing in 175 cases (30.1%), including 12 with stage G4/G5 disease. Women were more likely than men to lack uACR data (37.7% vs 22.1%; OR 2.13, 95% CI 1.48, 3.08; χ² = 16.78, p < 0.001). KDIGO high or very high risk was present in 179 (30.8%) and a combined high-risk profile in 118 (20.3%). Combined high-risk status clustered in the missed-escalation group (16/47, 34.0%) compared with the rest of the cohort (83/447, 18.6%; RR 1.83, 95% CI 1.18, 2.85; OR 2.26, 95% CI 1.18, 4.33; p = 0.020). Diabetes (n = 198, 34.1%) was not associated with coding accuracy, but was associated with higher risk CKD (30.3% vs 15.1%; χ² = 18.53, p < 0.001; RR 2.00; Cramér's V = 0.18) and more complete uACR testing (82.8% vs 63.2%; χ² = 23.93, p < 0.001). Separate case finding identified 38 additional adults with biochemical evidence of uncoded CKD.</p><p><strong>Conclusions/interpretation: </strong>Primary care CKD records exhibited multi-level clinical inertia across coding, stage review and albuminuria-based risk assessment. Missed reclassification, absent uACR data and uncoded disease clustered with higher-risk profiles and disparities disadvantaging women. Structured EHR-led CKD review processes that integrate longitudinal kidney function, mandatory uACR ordering, active code review and risk-based action may improve timeliness, equity of CKD care.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Room for Improvement: People living with diabetes in Canada are not receiving guideline-recommended preventive cardiovascular care: Analyses using the National Diabetes Repository.","authors":"Katharine Mackett, Nancy A Santesso, Diana Sherifali, Russell J de Souza, James M Bowen, Sylvie Dostie, Ruth Ndjaboue, Dana Tannenbaum Greenberg, Michelle Greiver, Holly O Witteman","doi":"10.1016/j.pcd.2026.09.003","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.09.003","url":null,"abstract":"<p><strong>Background: </strong>To reduce cardiovascular morbidity and mortality, people living with diabetes should receive guideline-recommended care. This study aimed to determine whether people living with diabetes in Canada received cardiovascular preventive care in accordance with the 2018 Diabetes Canada Clinical Practice Guidelines, and whether this care differed by sociodemographic factors.</p><p><strong>Methods: </strong>This retrospective cross-sectional study analyzed 83,799 records from the National Diabetes Repository in Canada, with at least one recorded outcome for the years 2021 and 2022. The percentage of individuals receiving guideline-recommended care was estimated and logistic regression were performed using R.</p><p><strong>Results: </strong>Of the 38,901 individuals, 56% had their blood pressure monitored, 36% had a recorded weight measurement, 12% received guideline-recommended laboratory monitoring for hemoglobin A1c (HbA1c), and 9% monitoring for lipids in 2022. Most measurements were for individuals aged 65 + years or urban residents. Of the 2% referred to dietetic services, urban residents were more likely to have a documented referral (adjusted odds ratio (aOR) 3.02, 95% confidence interval (CI) 2.32-4.00) compared to rural residents. Alternatively, urban residents were less likely to receive blood pressure monitoring (aOR:0.49, 95%CI:0.46-0.52). Approximately half were prescribed cardio-protective medications (i.e. statins). Such prescriptions were more likely for male versus female individuals (aOR:1.42, 95%CI:1.36-1.48). Younger participants aged 18-39 were more likely to be prescribed smoking cessation medication (aOR:3.35, 95%CI:2.77-4.04) than participants aged 65 +. Findings were similar in 2021.</p><p><strong>Conclusions: </strong>In 2021 and 2022, few people living with diabetes received guideline-recommended care, with some variation based on sociodemographic characteristics. Implementation strategies to improve care for people living with diabetes at risk of cardiovascular disease are needed across Canada.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in receipt of diabetes care between residents of metropolitan and non-metropolitan areas.","authors":"Jayline Tindall, Dmitry Tumin","doi":"10.1016/j.pcd.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.09.002","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to determine whether rural residence was associated with fewer diabetes-related healthcare visits than urban residence.</p><p><strong>Methods: </strong>We analyzed 2019-2021 Behavioral Risk Factor Surveillance System data from seven US jurisdictions that consistently administered an optional diabetes module. We included adults with a self-reported diabetes diagnosis and used weighted analyses and multivariable Poisson regression to compare the annual number of diabetes-related visits between rural and urban residents, adjusting for demographic, socioeconomic, and clinical variables.</p><p><strong>Results: </strong>Based on a sample of 12,931 respondents, we estimated that 24% lived in rural areas. The weighted mean number of diabetes-related visits over the past year was lower for rural compared to urban residents (2.8 vs 3.0, p = 0.036). In adjusted analysis, rural residence remained associated with fewer diabetes-related visits (incidence rate ratio: 0.92; 95% CI: 0.86, 0.98; p = 0.015), corresponding to -0.24 visits per year (95% CI: -0.43, -0.05).</p><p><strong>Conclusions: </strong>Rural residence was associated with lower use of diabetes-related health care, even after controlling for other factors, though these data cannot establish whether the difference reflects unmet need. Whether approaches such as telehealth expansion, reimbursement reform, or provider recruitment can narrow this difference warrants evaluation in future studies.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year progression from prediabetes to type 2 diabetes in a Turkish primary-care cohort: a prospective study.","authors":"Ayşen Sümer Tapur, Erdinç Yavuz, Nur Şimşek Yurt","doi":"10.1016/j.pcd.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.09.001","url":null,"abstract":"<p><strong>Aims: </strong>To estimate one-year progression to type 2 diabetes among adults with prediabetes in primary care and explore associated baseline characteristics.</p><p><strong>Methods: </strong>Adults with prediabetes identified using FPG, 2-h OGTT glucose and/or HbA1c criteria at a Turkish family health centre were followed for one year. Incident diabetes was defined by repeat-confirmed diabetes-range FPG or HbA1c; the oral glucose tolerance test was not repeated at follow-up, for resource and participant-burden reasons. Progressors and non-progressors were compared using Mann-Whitney U and Fisher's exact tests, without adjustment for multiple comparisons. ROC analyses were exploratory, and the derived cut-offs were neither internally nor externally validated.</p><p><strong>Results: </strong>Among 152 participants (67.8% women; mean age 52.9 ± 12.6 years), 9 (5.9%; 95% CI 2.7-10.9%) progressed to diabetes, while 20 had normal-range FPG and HbA1c and 123 retained prediabetes-range values. Progressors had higher BMI, waist and hip circumference, FPG, HbA1c and 2-h glucose; antidepressant use was also more frequent, although this unadjusted association is likely confounded by indication. All nine incident cases occurred in participants with combined IFG and IGT. In exploratory analyses based on only nine events, higher 2-h glucose showed the strongest apparent separation between progressors and non-progressors.</p><p><strong>Conclusions: </strong>One-year progression was uncommon but concentrated among participants with combined IFG and IGT. Because only nine events occurred, roughly two dozen baseline factors were compared without adjustment for multiple testing, and the OGTT was not repeated at follow-up, every association reported here is hypothesis-generating and the study-derived thresholds are exploratory and unvalidated; neither should be used to guide clinical decisions until confirmed in larger, independent cohorts.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of fixed-ratio combination of basal insulin and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in Asians with type 2 diabetes.","authors":"Alice Pik-Shan Kong, Chun-Kwan O, Siran Lai, Chih-Yuan Wang, Juliana Chung-Ngor Chan","doi":"10.1016/j.pcd.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.08.005","url":null,"abstract":"<p><p>People with type 2 diabetes in Asia have heterogeneous phenotypes but share common features of young age-at-diagnosis, low body mass index, low pancreatic beta-cell capacity, rapid decline in insulin secretion as well as visceral and ectopic fat excess. Cardiovascular diseases are the leading causes of mortality in people with diabetes. In clinical trial settings, despite receiving protocol-driven care, Asians had higher risk of chronic kidney disease than non-Asians. Aging and improved survival in people with diabetes continue to drive the epidemic of diabetes. People with old age, long disease duration and complications might benefit from both insulin to optimize glucose control and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for cardiovascular-renal protection. Complex therapies pose challenges in administration and adherence where fixed-dose combination such as basal insulin plus GLP-1 RA may improve safety, effectiveness and acceptability. In this narrative review, we summarized the efficacy and safety data from randomized controlled trials using iGlarLixi, a fixed-ratio combination of insulin glargine 100 U/mL (iGlar) and lixisenatide (Lixi), a short acting GLP-1 RA, studied widely in Asians. We discussed the guidelines on the use of this fixed-ratio combination illustrated by real-world case studies in older Asian adults with young-onset type 2 diabetes.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep well, but be active. Effect of sleep and sedentariness on incidence of diabetes.","authors":"Keyuan Liu, P. Marques-Vidal","doi":"10.1093/eurjpc/zwad125.106","DOIUrl":"https://doi.org/10.1093/eurjpc/zwad125.106","url":null,"abstract":"AIMS\u0000We aimed to determine the individual effect of long/short sleep and of inactivity on diabetes risk using data from a population-based prospective study in Switzerland.\u0000\u0000\u0000METHODS\u0000Prospective study with a median (min-max) follow-up of 9 (2.4-11.5) years. Incident diabetes was defined based on 1) fasting plasma glucose (FPG), 2) glycated hemoglobin (HbA1c), or 3) any diagnostic criterion (FPG, HbA1c or medical diagnosis). Sleep and sedentary levels were assessed by questionnaire. Sleep was categorized into short (<7 h/day), adequate (7-9 h/day) and long (>9 h/day).\u0000\u0000\u0000RESULTS\u0000Data from 3355 participants (57.6% women, mean age years 56.6 ± 10.3) was analyzed. There were 136, 110 and 142 incident cases of diabetes defined by FPG, HbA1c or any criterion, respectively. Participants who developed diabetes had a higher sedentariness but no differences were found regarding sleep duration. Similar results were obtained after adjusting for age, gender, education, smoking and body mass index: hazard ratio (95% confidence interval) for sedentariness 1.61 (1.11-2.35), 1.40 (0.93-2.12) and 1.39 (1.04-1.87) for diabetes defined by FPG, HbA1c or any diagnostic criterion, respectively.\u0000\u0000\u0000CONCLUSION\u0000Being sedentary, but not being a long or a short sleeper, increases the risk of developing diabetes.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42061845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Enhanced Primary Healthcare (EnPHC) interventions on Type 2 diabetes management in Malaysia: Difference-in-differences (DID) analysis.","authors":"M. Husin, X. Teh, S. M. Ong, Y. Lim, Swee Hung Ang, C. Chan, M. Lim, S. Shanmugam, Noraziani Khamis, Faeiz Syezri Adzmin Jaafar, Norliza Ibrahim, N. Nasir, D. Kusuma, A. Wagner, D. Ross-Degnan, R. Atun, S. Sivasampu","doi":"10.21203/RS.3.RS-154502/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-154502/V1","url":null,"abstract":"AIMS\u0000To evaluate the effectiveness of the Enhanced Primary Healthcare (EnPHC) interventions on process of care and intermediate clinical outcomes among type 2 diabetes patients.\u0000\u0000\u0000METHODS\u0000This was a quasi-experimental controlled study conducted in 20 intervention and 20 control public primary care clinics in Malaysia from November 2016 to June 2019. Type 2 diabetes patients aged 30 years and above were selected via systematic random sampling. Outcomes include process of care and intermediate clinical outcomes. Difference-in-differences analyses was conducted.\u0000\u0000\u0000RESULTS\u0000We reviewed 12,017 medical records of patients with type 2 diabetes. Seven process of care measures improved: HbA1c tests (odds ratio (OR) 3.31, 95% CI 2.13, 5.13); lipid test (OR 4.59, 95% CI 2.64, 7.97), LDL (OR 4.33, 95% CI 2.16, 8.70), and urine albumin (OR 1.99, 95% CI 1.12, 3.55) tests; BMI measured (OR 15.80, 95% CI 4.78, 52.24); cardiovascular risk assessment (OR 174.65, 95% CI 16.84, 1810.80); and exercise counselling (OR 1.18, 95% CI 1.04, 1.33). We found no statistically significant changes in intermediate clinical outcomes (i.e. HbA1c, LDL, HDL and BP control).\u0000\u0000\u0000CONCLUSIONS\u0000EnPHC interventions was successful in enhancing the quality of care, in terms of process of care, by changing healthcare providers behaviour.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45092402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of restricted diet with a plate in patients with type 2 diabetes: A randomized controlled trial.","authors":"Yongwen Zhang, Huanhuan Han, Lanfang Lanfang","doi":"10.22541/au.160552637.79851951/v1","DOIUrl":"https://doi.org/10.22541/au.160552637.79851951/v1","url":null,"abstract":"BACKGROUND\u0000In view of the complexity of dietary and nutritional education for most patients with type 2 diabetes mellitus (T2DM), a simplified approach called the \"restricted diet with a plate\" or \"plate model\" is recommended.\u0000\u0000\u0000PURPOSE\u0000To evaluate whether the plate model can effectively improve glycemic control and cardiovascular risk markers in type 2 diabetes mellitus (T2DM), while reducing the time devoted to education and avoiding weight gain.\u0000\u0000\u0000METHODS\u0000The study was a randomized, multicenter, controlled study, conducted between October 2018 and October 2019, among patients with T2DM living in Nanjing. The study included 419 participants who were randomly divided into a plate group and a counting group. The plate model included three components: a low-literacy, color leaflet containing the explanation and composition of the plate model, health education, and medical visits. Patients in the counting group received health education, group medical visits, and a paper booklet containing traditional carbohydrate counting education. Primary outcomes were glycemic control and weight.\u0000\u0000\u0000RESULTS\u0000Participants in the plate model reduced HbA1c by 0.7% in the first three months, and reduced to a greater extent at six months (1.44%), but this was not sustained, and HbA1c increased slightly over the following six months. Fasting plasma glucose (FPG) and 2-h postprandial glucose (2hPG) values were significantly reduced at the endpoint in the plate model (9.25 ± 1.72% vs. 7.44 ± 0.88%, P = 0.008; 12.07 ± 2.94 vs. 8.35 ± 1.99%; P = 0.004); however, the 2hPG values decreased most significantly. Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels decreased significantly in the plate group, which occurred at six months and lasted for 12 months. In the first three months, the average weight loss in the plate group was 1.2 kg/month (95% CI 0.92-1.48), and in the fourth to twelfth months, the average weight gain was 0.21 kg/month (95% CI 0.08-0.34). There was significant difference in education time between the groups (17.3 ± 4.42 vs. 38.6 ± 12.63; P < 0.001).\u0000\u0000\u0000CONCLUSIONS\u0000The plate model is at least as effective as the counting model over the short term for glycemic control and perhaps even better for weight and lipid control. Plate model has the potential to improve education of those with low health literacy by reducing reading demands.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42015834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}