Time of Exposure and Type of Diabetes May Determine Treatment Outcome of Group Clinics
Authors: Massimo Porta, Marina Trento
Journal: Annals of Internal Medicine (2010)

Letters5 October 2010Time of Exposure and Type of Diabetes May Determine Treatment Outcome of Group ClinicsMassimo Porta, MD, PhD and Marina Trento, MEdSci, MBAMassimo Porta, MD, PhDFrom University of Turin, 10126 Turin, Italy.Search for more papers by this author and Marina Trento, MEdSci, MBAFrom University of Turin, 10126 Turin, Italy.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-7-201010050-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Edelman and colleagues (1) report encouraging clinical results from group medical clinics in patients with diabetes mellitus and hypertension. However, they observed that benefits of the group approach were limited to improvements in blood pressure rather than better control of glycated hemoglobin. We would like to offer an alternative interpretation for their inability to improve metabolic control.First, in an early randomized, controlled clinical trial (reference 15 in the article by Edelman and colleagues), we were able to improve hemoglobin A1c levels together with quality of life and health behaviors by using a similar group-care approach (7 ...References1. Edelman D, Fredrickson SK, Melnyk SD, Coffman CJ, Jeffreys AS, Datta S, et al. Medical clinics versus usual care for patients with both diabetes and hypertension: a randomized trial. Ann Intern Med. 2010;152:689-96. [PMID: 20513826] LinkGoogle Scholar2. Trento M, Passera P, Borgo E, Tomalino M, Bajardi M, Cavallo F, et al. A 5-year randomized controlled study of learning, problem solving ability, and quality of life modifications in people with type 2 diabetes managed by group care. Diabetes Care. 2004;27:670-5. [PMID: 14988283] CrossrefMedlineGoogle Scholar3. Trento M, Borgo E, Kucich C, Passera P, Trinetta A, Charrier L, et al. Quality of life, coping ability, and metabolic control in patients with type 1 diabetes managed by group care and a carbohydrate counting program [Letter]. Diabetes Care. 2009;32:134. [PMID: 19875597] CrossrefMedlineGoogle Scholar4. Trento M, Basile M, Borgo E, Grassi G, Scuntero P, Trinetta A, et al. A randomised controlled clinical trial of nurse-, dietitian- and pedagogist-led group care for the management of type 2 diabetes. J Endocrinol Invest. 2008;31:1038-42. [PMID: 19169063] CrossrefMedlineGoogle Scholar5. Trento M, Gamba S, Gentile L, Grassi G, Miselli V, Morone G, et al; ROMEO Investigators. Rethink Organization to iMprove Education and Outcomes (ROMEO): a multicenter randomized trial of lifestyle intervention by group care to manage type 2 diabetes. Diabetes Care. 2010;33:745-7. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Turin, 10126 Turin, Italy.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMedical Clinics Versus Usual Care for Patients With Both Diabetes and Hypertension David Edelman , Sonja K. Fredrickson , Stephanie D. Melnyk , Cynthia J. Coffman , Amy S. Jeffreys , Santanu Datta , George L. Jackson , Amy C. Harris , Natia S. Hamilton , Helen Stewart , Jeannette Stein , and Morris Weinberger Time of Exposure and Type of Diabetes May Determine Treatment Outcome of Group Clinics David Edelman Metrics Cited byAngiotensin receptor blockade in diabetic women of childbearing potential: an acceptable risk? 5 October 2010Volume 153, Issue 7Page: 483KeywordsBlood pressureHemoglobinHypertensionInsulinInsulin resistancePatientsQuality of lifeType 1 diabetesType 2 diabetes ePublished: 5 October 2010 Issue Published: 5 October 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...