Il modello di disease management “Gestione Integrata”: l’esperienza di una popolazione afferente all’Ambulatorio di Malattie del Metabolismo e Diabetologia dell’AOU San Luigi Gonzaga nel periodo 2008-2014

AIMS: To compare clinical, disease characteristics and the clinical outcomes of the population with type 2 diabetes not included in the Integrated Management program (IM) with a population included in the IM program. METHODS: A perspective study has been conducted. Differences between clinical characteristics were analysed according to a univariate and multivariate logistic regression model, calculating the OR and its 95% confidence intervals as well as p significance values. A multivariate model was built from univariate analysis. The variations of the clinical indexes have been studied by the first to the last survey appraising the reductions percentages of the same in the two populations. RESULTS: The univariate analysis showed that on enrollment IM patients are more likely women, under 50 years of age at diagnosis, on diet therapy, with weight lower than 70 kg and BMI. HbA1c is also lower, as well as creatinine and triglycerides, while HDL is higher. The multivariate confirmed the results of the univariate, to exception of weight, BMI and HDL. At the multivariate at follow-up the results of the multivariate at enrolment were confirmed, with few variations. Considering the differences of clinical values an improvement of all clinical parameters were observed excepted for creatinine. No differences among variations gotten by the patient in IM in comparison to those not in IM but these differences excepted for creatinine and HbA1c. CONCLUSIONS: No big differences in management between GPs and CDs, so metabolically stable patients can be assigned to GPs, with the support of the specialist unit.