Risk factor management in stable, insulin-treated patients with Type 2 diabetes: The Diabetes Outcomes in Veterans Study

Glen H. Murata, Jayendra H. Shah, Christopher S. Wendel, Richard M. Hoffman, Karen D. Adam, Syed U. Bokhari, Patricia A. Solvas, William C. Duckworth

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Objectives: Describe the methodologies and study population of the Diabetes Outcomes in Veterans Study (DOVES). Research Design and Methods: Prospective, multicenter, observational study of Southwestern veterans with stable, insulin-treated Type 2 diabetes. Subjects were randomly selected from pharmacy records and were required to be using at least one long-acting insulin preparation daily. Baseline psychosocial evaluations included psychological status, social and cultural barriers to care, self-care behaviors, and vascular disease risk factors. Clinical measurements included self-reported vascular disease, hemoglobin A1c (HbA1c), blood pressure, blood lipids, and body mass index (BMI). A subset of subjects completed a protocol of four times daily self-monitored blood glucose testing for 8 weeks. Subjects were followed for 12 months. Principal endpoints included glycemic control, the occurrence of hypoglycemia, and control of vascular disease risk factors. Results: We enrolled 338 subjects. The mean (±S.D.) age was 65.1±9.7 years and 3.8% were women. At baseline, over two-thirds of subjects reported vascular disease complications. Nearly three-quarters had limited physical activity. Among subjects younger than 65 years, 53% considered themselves disabled for work. Despite the high prevalence of vascular disease, 43.8% had an HbA1c ≥8.0%. Many subjects were sedentary, 62.1% had a BMI of 30 kg/m2 or above, and 22.2% were still smoking. Conclusions: Detailed measurements of psychological status, self-care behaviors, and risk factor control are feasible in this elderly, debilitated population. Although the prevalence of complications and self-rated disability was high, vascular disease risk factors were poorly controlled in a substantial proportion of subjects.

Original languageEnglish (US)
Pages (from-to)186-191
Number of pages6
JournalJournal of Diabetes and its Complications
Volume17
Issue number4
DOIs
StatePublished - Jan 1 2003
Externally publishedYes

Keywords

  • Diabetes mellitus
  • Hyperglycemia
  • Risk factors
  • Self-care
  • Vascular diseases

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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