Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.
A mnemonic-based strategy in which each letter of the alphabet refers to a different component of diabetes care can help clinicians limit complications that typically result from the disease, say researchers. See Last weeks Tools for Your Practice “The ABCDEFGHI’s of diabetes.
Dr. James Douglas Lee, with the George Eliot Hospital in Nuneaton, UK, presented results on August 26th at the Eighteenth International Diabetes Federation (IDF) Congress, of 400 consecutive diabetic outpatients who were maintained on the strategy for a mean of 5 years.
The various components of the so-called Alphabet Strategy are as follows:
· A refers to advice for regular exercise, dietary change, and smoking cessation.
· B is for blood pressure, with a target of less than 140/90 mm Hg.
· C is for cholesterol profile, which aims for a total cholesterol less than 5 mmol/L and a low-density lipoprotein/high-density (LDL/HDL) lipoprotein cholesterol ratio less than 3 mmol/L. C also refers to creatinine care, meaning regular microalbuminuria assessment.
The remaining letters each stand for additional aspects of diabetes care.
Five-year follow-up results show that there was a non-significant decrease in the% of patients who smoked from 18.3 to 15.5%. Blood pressure decreased significantly from 146/82 mm Hg to 141/77 mm HG. Total cholesterol decreased from 5.8 to 4.9 mmol/L, and HDL-cholesterol increased from 1.05 to 1.26 mmol/L.
The percent of patients undergoing yearly foot and eye examinations also increased significantly.
Haemoglobin A1 C values significantly deteriorated, increasing from 7.9 to 8.1% over the 5-year study.
"The results show that the Alphabet Strategy can be a useful tool for ensuring the appropriate care of diabetic patients," Dr. Lee said.
IDF: [Study title: Implementation of the alphabet strategy improves cardiovascular risk estimates in type 2 diabetes mellitus: the alphabet POEM project. Abstract 42]