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 .
Randomized trial of a whole-system ayurvedic protocol for type 2 diabetes.
CONTEXT Though complementary and alternative medicine ( CAM ) treatments are popular , evidence to support their application to diabetes care is scarce . Previous CAM diabetes research has generally focused on single modalities , but CAM practitioners more commonly prescribe complex , multimodality interventions . OBJECTIVES The aims of this study were to determine the feasibility and clinical impact of a whole-system , Ayurvedic intervention for newly diagnosed people with type 2 diabetes . DESIGN Patients were r and omly assigned to either an experimental or control arm . SETTING Group model health maintenance organization . PARTICIPANTS We recruited 60 adult patients with baseline glycosylated hemoglobin ( HbA1c ) values between 6.0 and 8.0 . INTERVENTION Treatment for the experimental group included exercise , an Ayurvedic diet , meditation instruction , and an Ayurvedic herb supplement ( MA 471 ) . Control patients attended st and ard diabetes education classes with primary care clinician follow-up . MEASUREMENTS Clinical outcomes were assessed at 3 and 6 months and included HbA1c , fasting glucose , lipids , blood pressure , and weight . RESULTS Ninety-two percent of r and omized patients completed the study , and there were no significant adverse study -related events . Using analysis of co-variance ( ANCOVA ) , we found no significant differences for clinical outcomes at 6 months between on- study patient groups , though trends favored the Ayurvedic group . When we included a factor measuring how much baseline HbA1c exceeded the mean ( 6.5 % ) , however , we found statistically significant improvements in the Ayurvedic group for HbA1c ( P = .006 ) , fasting glucose ( P = .001 ) , total cholesterol ( P = .05 ) , low-density lipoprotein ( LDL ) cholesterol ( P = .04 ) , and weight ( P = .035 ) . CONCLUSIONS These results suggest that the Ayurvedic intervention may benefit patients with higher baseline HbA1c values , warranting further research
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 .