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- July 4, 2008 |
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CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
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"Diabetes Care and Outcomes in Ontario"Dr. Gillian Booth (biography)
English - 2002-01-19 - 25 minutes
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Summary :
Discussion on medical care for diabetes in Ontario. Statistical information providing an overview on the geographic distribution of diabetes in Ontario, as well as the quality and type of medical care offered.
Learning objectives :
Upon completion of this presentation, participants should be able to:1. Learn how administrative data can be used to study the quality of care and outcomes of diabetes in Ontario.2. Understand how well guidelines for diabetes care are generally adhere
Bibliographic references :
Diabetes care in the u.s. And Canada.
Booth GL, Zinman B, Redelmeier DA.
Department of Medicine St. Michael's Hospital, Toronto, Ontario, Canada. Mount Sinai Hospital, Toronto, Ontario, Canada. Sunnybrook and Women's College Health Science Centre, University of Toronto, Toronto, Ontario, Canada.
OBJECTIVE-To compare the glycemic control of patients with type 1 diabetes treated in the U.S. and Canada.
RESEARCH DESIGN AND METHODS-A large multicenter randomized clinical trial conducted in the U.S. and Canada was analyzed. Patients with type 1 diabetes, screened from 1983 to 1989 for enrollment in the Diabetes Control and Complications Trial (DCCT), were categorized as treated in the U.S. (n = 2,604) or Canada (n = 245). HbA(1c) levels were compared between U.S. and Canadian patients, both before and after adjustment for predictors of HbA(1c).
RESULTS-In general, volunteers screened for the DCCT were highly educated and following healthy lifestyles. Canadians were somewhat younger (25 vs. 27 years of age, P = 0.002), less likely to be college educated (62 vs. 71%, P = 0.002), more likely to receive care through a family doctor (41 vs. 28%, P = 0.001), and had a higher frequency of out-patient visits (4 vs. 3 per year, P = 0.004). Despite these differences in health care delivery, the mean HbA(1c) at baseline was identical in the two countries (8.9 vs. 9.0, P = 0.40). Adjustment for demographic, lifestyle, andclinical predictors of HbA(1c) yielded similar findings (9.0 vs. 9.2, P = 0.15). Equal percentages of American and Canadian patients who were screened ultimately entered the trial (21 vs. 19%, P = 0.20), and those randomized to conventional care achieved similar mean HbA(1c) levels (9.1 vs. 9.2, P = 0.50).
CONCLUSIONS-Differences in care delivery patterns do not yield large differences in glycemic control for patients with type 1 diabetes who were recruited in the U.S. and Canada for a large randomized trial.
Diabetes Care 2002 Jul;25(7):1149-53
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