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. 2023 May 31;2023(5):CD014513. doi: 10.1002/14651858.CD014513

Duran 2008.

Study characteristics
Methods Family physician and endocrinologist coordination as the basis for diabetes care in clinical practice
Patient RCT, conducted in St Carlos Hospital, Spain
Two arms: 1. Group A (control arm) and 2. Group B (intervention arm)
Participants Control arm N: 63
Intervention arm N: 63
Diabetes type: type 2
Mean age: 70 (range: 57 to 76)
% Male: 70.8
Longest follow‐up: 30 months
Interventions Control arm:
None
Intervention arm:
1) Team changes
2) Clinician education
Outcomes 1) HbA1c, median % (SD)
Control arm: pre 7.2 (1.5), post 7.3 (1.0)
Intervention arm: pre 7.2 (2.0), post 7.1 (1.4)
2) SBP, median mmHg (SD)
Control arm: pre 140.0 (14.8), post 130.0 (7.4)
Intervention arm: pre 145.0 (20.7), post 135.0 (19.3)
3) DBP, median mmHg (SD)
Control arm: pre 80.0 (8.9), post 76.0 (6.7)
Intervention arm: pre 85.0 (10.4), post 78.0 (8.2)
4) LDL, median mg/dL (SD)
Control arm: pre 104.0 (30.4), post 78.0 (12.6)
Intervention arm: pre 107.0 (36.3), post 81.0 (20.0)
5a) Controlled hypertension (DBP < 80 mmHg), N under control (%)
Control arm: pre 30 (53), post 47 (82)
Intervention arm: pre 27 (46), post 51 (86)
5b) Controlled hypertension (SBP < 130 mmHg), N under control (%)
Control arm: pre 12 (21), post 29 (51)
Intervention arm: pre 14 (24), post 25 (42)
6) Smoking cessation, N smokers (%)
Control arm: pre 11 (19), post 7 (12)
Intervention arm: pre 11 (19), post 7 (12)
Funding source The foot care programme was partially supported by grants from the European Union, Sociedad Española de Endocrinología y Nutrición, Fundación Fernandez Cruz and Fundación del Servicio de Endocrinologia y Nutrición
Notes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Not reported.
Allocation concealment (selection bias) Unclear risk Not reported.
Patient's baseline characteristics (selection bias) Unclear risk Table 1: no P values reported, but looks balanced.
Patient's baseline outcomes (selection bias) Low risk See Table 2, P values > 0.05.
Incomplete outcome data (attrition bias) Low risk 6 lost in group A (9.5%) and 4 lost in group B (6%), reasons provided.
Blinding of participants and personnel (performance bias) and of outcome assessors (detection bias) Low risk Objective measurement of outcomes.
Selective reporting (reporting bias) High risk Retrospectively registered; apolipoprotein A1, apolipoprotein B and bodyweight not reported.
Risk of contamination (other bias) Low risk Group A treated at hospital and Group B treated at primary healthcare centre; unlikely to have received the same treatment.
Other bias Low risk No other evidence of risk of bias.