Teaching patients to monitor their risk factors retards the progression of vascular complications in high‐risk patients with Type 2 diabetes mellitus—a randomized prospective study

AbstractAims Intensive management of risk parameters in diabetic patients may retard the progression of both micro‐ and macrovascular complications. Intensified care requires expert staff and is expensive. The aim of the present study was to examine whether sharing the therapeutic responsibility with the patients will improve the outcome.Methods A randomized prospective study of 165 patients with diabetes mellitus Type 2, hypertension (> 140/90 mmHg) and hyperlipidaemia (LDL‐C > 120 mg/dl). Patients were randomly allocated to standard annual consultation (SC) or to a patient participation programme (PP). The medical care for both groups was administered by primary care physicians, who were unaware of the nature of the intervention.Results At 4 years the mean blood pressure was 148/88 (± 6.1/1.7) mmHg in the SC patients vs. 142/84 (± 5.8/1.8) mmHg in the PP group (P = 0.02). The mean LDL‐C was 124 ± 8 and 114 ± 6 mg/dl (P = 0.01) and the mean HbA1c was 8.9 ± 1.2% and 8.2 ± 1.5% (P = 0.04) in the SC and PP groups, respectively. The average annual fall in estimated glomerular filtration rate was 3.5 ml/min per year in the SC group vs. 2.25 in the PP group (P < 0.05). Albumin/