A healing degree system given that outlined by Article L 6321-hands down the Public Health Code was developed inside 2003 within the a south town of the fresh company out of Aisne ( French minister for solidarity and you may wellness, 2016 ; Legifrance, 2016 ). It was comprised of certain players, a lot of them mind-employed: general therapists, nurses, podiatrists, pharmacists, medical professionals, sporting events instructors, biologists, psychologists, artwork therapists, secretaries, and you can diligent advocates. It spent some time working together with the 2 medical facilities in your community in addition to towards municipality into the a reaction to the newest demands of your own people. He’s offered over a lot of people for the past fifteen years, for the purpose away from decreasing the Body mass index and you will HbA1c regarding acting customers. Having hindsight, the thing that was new impression for the healing patient degree network into the location? Part of the goal of your own analysis would be to evaluate the outcomes of the circle toward Bmi and you may HbA1c of customers that have type 2 diabetes monitored from . New secondary goal was to determine brand new change the patients’ modified exercise and you will therapeutic studies sessions starred on one or two medical center-physical parameters chose.
A keen observational, decimal, retrospective, and you will monocentric study is presented. The information collection concerned how many healing diligent training courses and you may adapted exercises together with advancement off HbA1c and you will Bmi of clients that have diabetes immediately after the overseeing on community anywhere between 2013 and 2018. The fresh new neighborhood included in the newest circle try 30 kilometers that have a prevalence away from all forms of diabetes at the 4.9% in 2007 ( France Tv, 2014 ). A consult was made towards network’s board from directors so you’re able to seek their arrangement to manage the research. Suggestions are wanted to people through the network’s newsletter. The information and knowledge range months endured out of , add up to the latest computerization of network because of the Logireso® app. Earlier in the day data wasn’t offered to the fresh new specialist. The newest inclusion standards regarding research was basically: an unbalanced diabetic issues (>7%) and you will a minimum realize-upwards of half a year on the circle allowing for three HbA1c specifications that have at least pit out of 90 days anywhere between for every studies. This caused it to be it is possible to to retain logical and biological sized HbA1c and you can Bmi in the very beginning of the treatment course, at the middle-term and also at the end of the latest recommended overseeing.
Customers had been led on community by their doctor getting imbalanced diabetes (HbA1c above the target diversity with the person’s years and you can comorbidities) and you can constant comorbidities on the sedentary lives otherwise obesity. Several details (decades, intercourse, time of keeping track of, level of therapeutic degree coaching and modified regular activities performed by the the average person, and HbA1c and you may Bmi dimensions) had been collected. The new lost guidance regarding network file was complete of the contacting possibly the brand new person’s planning medical practitioner or even the city’s scientific biology labs. The latest entryway from anonymized investigation are complete into the a be noticed® spreadsheet.
Statistical data was did using SPSS® application. The fresh new decimal data try joined on the Student’s t decide to try getting matched products (clinic-biological specifications). A great linear regression test, having calculation of your own linear regression coefficient Roentgen? is actually performed to evaluate the potency of relationship amongst the examined details. The variety of thinking is laid out to-be between no and one. Brand new better the result involved that, the greater amount of legitimate the fresh regression. The significance peak was put on 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, ek kaynaklar 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 ).