Less frequently reported were quality of life , patient satisfaction , self-care , and healthcare utilization .
Most care management modalities were carved out from primary care .
Conclusions Most care management programs for patients with type 2 diabetes are ' carved-out ' , accomplish limited effects on metabolic outcomes , and have unknown effects on patient important outcomes .
Background This systematic review and meta- analysis aims at assessing the composition and performance of care management models evaluated in the last decade and their impact on patient important outcomes .
Decreasing the risk of diabetic retinopathy in a study of case management: the California Medi-Cal Type 2 Diabetes Study.
OBJECTIVE Diabetic retinopathy affects > 60 % of people with type 2 diabetes during the first 2 decades of the disease and is ameliorated by good glycemic control . This study tested whether intensive diabetes case management could prevent or delay diabetic retinopathy in patients with established type 2 diabetes . RESEARCH DESIGN AND METHODS This study was part of a r and omized , controlled clinical trial of diabetes case management  in type 2 diabetes in southern California counties serving low income ethnic minority population s. Subjects were r and omized to intervention ( diabetes case management ) or control ( traditional treatment ) groups . Subjects with at least two retinal photographs ( n = 149 ) were included in this analysis to assess the effect of intervention on development or progression of diabetic retinopathy . RESULTS Progression of retinopathy in the intervention group was not significantly less than in the control group ( P = 0.226 ) . However , those in the intervention group with no evidence of retinopathy at baseline were less likely to develop diabetic retinal changes ( 5/48 ) during a mean follow-up of 23.1 months than those in the control group ( 10/34 , chi(2 ) = 4.805 , P = 0.028 ) . This difference remained significant in a logistic regression model that controlled for potential confounders ( odds ratio 5.35 [ 95 % CI 1.14 - 25.12 ] ) . CONCLUSIONS This study shows that a relatively short duration of case management instituted before the onset of clinical ly identifiable retinopathy significantly diminished the risk of developing retinopathy in patients with type 2 diabetes . The findings also emphasized the retinal disease burden in this population , with development and progression of retinopathy occurring in < 2 years
Less frequently reported were quality of life , patient satisfaction , self-care , and healthcare utilization .
Most care management modalities were carved out from primary care .
Conclusions Most care management programs for patients with type 2 diabetes are ' carved-out ' , accomplish limited effects on metabolic outcomes , and have unknown effects on patient important outcomes .
Background This systematic review and meta- analysis aims at assessing the composition and performance of care management models evaluated in the last decade and their impact on patient important outcomes .