A healing knowledge network given that discussed by Post L 6321-1 of the Social Health Password is made in the 2003 inside a southern town of new agencies from Aisne ( French minister to have solidarity and you can health, 2016 ; Legifrance, 2016 ). It actually was comprised of some users, several notice-employed: general therapists, nurses, podiatrists, pharmacists, dieticians, sporting events educators, biologists, psychologists, ways practitioners, secretaries, and you will diligent advocates. They worked in partnership with the two hospitals in your neighborhood including toward municipality when you look at the a reaction to the fresh need of your own population. They have offered more than a lot of customers over the past fifteen years, with the aim regarding decreasing the Body mass index and you can HbA1c off acting patients. Having hindsight, that was the newest impact for the healing diligent degree circle on the location? The main goal of research would be to measure the consequences of the circle towards Bmi and HbA1c regarding clients that have type 2 diabetes monitored away from . The fresh new additional mission were to dictate the new affect the patients’ adapted exercise and you may therapeutic education instructions starred on a few medical center-biological details chosen.
An enthusiastic observational, decimal, retrospective, and you can monocentric investigation try presented. The data collection concerned exactly how many healing diligent knowledge training and you can adapted exercises plus the advancement out-of HbA1c and Bmi regarding clients having diabetes once the overseeing from the system anywhere between 2013 and you can 2018. The fresh local area protected by brand new system are 29 kilometers with a prevalence off diabetic issues in the cuatro.9% within the 2007 ( France Television, 2014 ). A request was made with the network’s board off directors to seek their arrangement to control the study. Guidance was accessible to clients via the network’s publication. The data collection months live of , comparable to the latest computerization of your network of the Logireso® app. Previous studies was not open to the brand new researcher. Brand new introduction criteria from the research was in fact: an unbalanced diabetic issues (>7%) and a minimum pursue-upwards regarding half a year about system allowing for about three HbA1c specifications with the very least gap out of 3 months between for each study. This made it you’ll to hold logical and you can biological measurements of HbA1c and Body mass index in the very beginning of the course of treatment, during the mid-title and also at the termination of the fresh recommended monitoring.
People were directed into the community by their doctor to have unbalanced diabetes (HbA1c over the target variety towards the patient’s years and you can comorbidities) and you will regular comorbidities for the inactive life or obesity. Some data (many years, intercourse, lifetime of overseeing, amount of healing studies sessions and you may modified activities did by the the average person, and you can HbA1c and Bmi dimensions) was indeed collected. The brand new forgotten information regarding system document is done of the contacting possibly the person’s attending doctor and/or city’s health-related biology labs. The latest entryway out of anonymized study is actually over on a shine® spreadsheet.
Mathematical studies was performed using SPSS® app. datingranking.net local hookup Virginia Beach VA New decimal research is entered with the Student’s t try for matched products (clinic-biological proportions). A good linear regression sample, which have formula of the linear regression coefficient R? are did to evaluate the effectiveness of correlation amongst the analyzed details. All of the philosophy try defined as anywhere between no and you can you to. Brand new closer the result concerned you to definitely, the more reputable the fresh new regression. The significance peak are set during the 0.05.
The study included 282 patients with an age range from 41 to 84 over a five-year period. Only 59 patients met the inclusion criteria (20.9%). Among the patients not included, 69 did not have sufficient monitoring to be able to analyze an effect on the clinic-biological measures (less six month) or had type 1 diabetes, 32 patients refused monitoring by the network after a first meeting, and 123 had incomplete data in their file in HbA1C or BMI. Among the patients included, 59% of them were women, and the average age was 64 years old. The mean duration of monitoring was 23.8 months [6, 53] with a median of 21 months. The patients had completed an average of ten sessions of adapted physical activities [0, 93] and sixteen therapeutic patient education sessions [0, 73]. In regard to the variation in the BMI of the population studied, the average BMI at the start of the treatment course was 34.1 kg/m?, at the middle of the monitoring 33.2 kg/m?, and at the end of the monitoring 32.9 kg/m?. Throughout the monitoring, the BMI dropped significantly at the mid-term –0.94 kg/m? (p < 0.001) and –1.65 kg/m? (p < 0.001) at the end of the monitoring period. Likewise, the mean HbA1c at entry was 7.5%, at mid-course 6.9%, and at end of follow-up 6.6%. The decrease in absolute HbA1c at mid-term was –0.61% (p < 0.001) and –0.86% (p < 0.001) at the end of the monitoring period. The decreases observed in the two analyses were more marked during the first half of the monitoring period. This decrease was greater when the initial values were high. Regarding the tests on the absolute values, no link was found between the decrease in BMI and the number of sessions of adapted physical activities (p = 0.74) or with the number of therapeutic patient education sessions (p = 0.66), nor between HbA1c and adapted physical activity (p = 0.63) or the number of therapeutic patient education sessions (p = 0.73). However, the analysis of the impact of the participation of patients in the network on the absolute value of HbA1c found a very marked downward curve (p < 0.001) with a regression coefficient, R? = 0.7, confirmed by the distribution of points very close to the line of regression (Figure 1 ).