BACKGROUND To evaluate the impact of integrating diabetes education teams in primary care on glycemic control, lipid, and blood-pressure management in type 2 diabetes patients. METHODS A historical cohort design was used to assess the integration of teams comprising nurse and dietitian educators in 11 Ontario primary-care sites, which delivered individualized self-management education. Of the 771 adult patients with A1C ≥ 7% recruited, 487 patients attended appointments with the diabetes teams, while the remaining 284 patients did not. The intervention's primary goal was to increase the proportion of patients with A1C ≤7%. Secondary goals were to reduce mean A1C, low-density lipoprotein, total cholesterol-high density lipoprotein, and diastolic and systolic blood pressure, as recommended by clinical-practice guidelines. RESULTS After 12 months, a higher proportion of intervention-group patients reached the target for A1C, compared with the control group. Mean A1C levels fell significantly among all patients, but the mean reduction was larger for the intervention group than the control group. Although more intervention-group patients reached targets for all clinical outcomes, the between-group differences were not statistically significant, except for A1C. CONCLUSIONS Nurse and dietitian diabetes-education teams can have a clinically meaningful impact on patients' ability to meet recommended A1C targets. Given the study's historical cohort design, results are generalizable and applicable to day-to-day primary-care practice. Longer follow-up studies are needed to investigate whether the positive outcomes of the intervention are sustainable.

中文翻译：

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评估现场糖尿病教育团队在初级保健中对临床结果的影响。

背景技术为了评估在初级保健中整合糖尿病教育团队对2型糖尿病患者的血糖控制，脂质和血压管理的影响。方法采用历史队列设计评估安大略省11个初级保健场所中由护士和营养师教育者组成的团队的整合情况，这些团队提供了个性化的自我管理教育。在招募的771名A1C≥7％的成年患者中，有487名患者参加了糖尿病小组的约诊，而其余284名患者没有参加。干预的主要目标是增加A1C≤7％的患者比例。次要目标是按照临床实践指南的建议，降低平均A1C，低密度脂蛋白，总胆固醇-高密度脂蛋白以及舒张压和收缩压。结果12个月后，与对照组相比，干预组患者达到A1C目标的比例更高。所有患者的平均A1C水平均显着下降，但干预组的平均下降幅度大于对照组。尽管更多的干预组患者达到了所有临床结局的目标，但除A1C外，组间差异无统计学意义。结论护士和营养师糖尿病教育团队可以对患者达到推荐的A1C目标的能力产生临床意义的影响。根据研究的历史队列设计，结果可以推广并适用于日常初级保健实践。需要更长的随访研究来调查干预的积极结果是否可持续。与对照组相比，干预组患者达到A1C目标的比例更高。所有患者的平均A1C水平均显着下降，但干预组的平均下降幅度大于对照组。尽管更多的干预组患者达到了所有临床结局的目标，但除A1C外，组间差异无统计学意义。结论护士和营养师糖尿病教育团队可以对患者达到推荐的A1C目标的能力产生临床意义的影响。根据研究的历史队列设计，结果可以推广并适用于日常初级保健实践。需要更长的随访研究来调查干预的积极结果是否可持续。与对照组相比，干预组患者达到A1C目标的比例更高。所有患者的平均A1C水平均显着下降，但干预组的平均下降幅度大于对照组。尽管更多的干预组患者达到了所有临床结局的目标，但除A1C外，组间差异无统计学意义。结论护士和营养师糖尿病教育团队可以对患者达到推荐的A1C目标的能力产生临床意义的影响。根据研究的历史队列设计，结果可以推广并适用于日常初级保健实践。需要更长的随访研究来调查干预的积极结果是否可持续。