Table 3

Summary of the benefits from programmes which produced improvements

StudyStatistically significant benefitsOther outcome measures
Cadario et al30Comparison between intervention and control groups:
  • Intervention group had improvement in HbA1c immediately post-transfer (7.9±1.0% vs 9.1±0.4%, p<0.01) while control group had no significant change

  • At 1 year post-transfer: intervention group had significant decrease in HbA1c compared to baseline (∆mean±SEM=0.5±0.3%, p<0.05) while control group had a statistically insignificant increase in HbA1c; overall, intervention group had lower HbA1c than control (8.9±0.5% vs 7.8±0.5%, p<0.01)

  • Improved clinic attendance rate at 1 year post-transfer in intervention vs control groups (80.0±12.5% vs 57.0±5.0%, p<0.05)

  • Improved self reported rates of foot examinations, microalbuminuria screening, HbA1c monitoring, eye assessment for intervention vs control groups

▶ No significant difference in HbA1c at 3 years post-transfer
Gholap et al27Intervention group compared with recent figures from multicentre study:
  • Significantly lower HbA1c (8.4 vs 9.5%, p<0.001)

  • Significantly higher rates of blood pressure monitoring (100% vs 88%, p<0.001)

  • Significantly better screening rates for nephropathy (80% vs 56%, p<0.01)

  • Significantly lower rates of microalbuminuria/proteinuria (5% vs 21%, p<0.02)

  • No significant differences in rates of hypertension or retinopathy

  • Statistical significance not stated for difference in clinic non-attendance rates (12% intervention group vs 24.6% multicentre study)

Holmes-Walker et al32Single group, compared with baseline:
  • Significant fall in HbA1c (8.8±1.9% vs 9.3±2.17%, p<0.001)

  • Significant reduction in diabetic ketoacidosis (DKA) admissions (incidence density ratio 0.62, 95% CI 0.39, 0.99, p<0.05)

  • Significant reduction in length of stay of readmissions (R2=0.46, p=0.02)

Lane et al25Comparison between intervention and control groups:
  • Greater fall in HbA1c in the tertile with highest starting HbA1c in intervention vs control groups (p<0.05 stated: exact figures not given)

  • Significantly lower rate of hypertension (p<0.03) in the intervention group

  • No significant difference in HbA1c between intervention and control groups as a whole

  • No significant difference in rates of DKA, microalbuminuria or clinic attendance

Nakhla et al31Comparison between existing groups:
  • Improved continuity group were significantly less likely to be admitted to hospital for their diabetes in the 2 years after transfer (RR of 0.23 (95% CI 0.05 to 0.79) for diabetes-related hospitalisation)

Vidal et al33Single group, compared with baseline:
  • Improvement in HbA1c (8.5±1.7% vs 7.4±1.4%, p<0.001)

  • Decrease in hypoglycaemic episodes (0.39 vs 0.14 per year, p<0.001)

  • Increased proportion of patients able to self-adjust insulin doses (13% vs 48%, p<0.001)

  • Improved knowledge of diabetes management (DKQ2 scores 25/35 vs 29/35, p<0.001)

  • No significant difference in diabetes related quality of life score

  • Increased proportion of rapid-acting insulins used (52% vs 23%, p<0.001)