Randomized study of two different target levels of glycemic control within the acceptable range in type 2 diabetes - Effects on well-being at 1 year

OBJECTIVE - A randomized trial with 1-year follow-up was conducted in 23 general practices to study the relationship between target values for glycemic control and well-being in type 2 diabetes. RESEARCH DESIGN AND METHODS - A total of 176 patients with type 2 diabetes, aged 40-75 years, were included. General practitioners were encouraged to make decisions according to a standardized step-up regimen until the target level of glycemic control was reached. The random allocation to a strict or a less strict target level of glycemic control (fasting capillary glucose <6.5 or <8.5 mmol/l), change in HbA(1c) and fasting glucose, and initiating insulin or treatment with oral hypoglycemic agents were studied as putative determinants of scores on a type 2 diabetes symptom checklist, a profile of mood states, an affect balance scale, and general well-being. Adjustments were made for baseline scores on the outcome at issue. RESULTS - Positive affect (an odds ratio [OR] [95% CI] of 0.39 [0.19-0.83]) and perceived treatment burden (OR 0.48 [0.23-0.98]) were unfavorably altered in the group randomly allocated to stricter target levels (fasting capillary glucose <6.5 mmol/l). Patients who had a decrease in HbA(1c) of 1% or more tended to have comparatively favorable mood (OR displeasure score 0.35 [0.13-0.94]) and general well-being scores at 1 year (ORs of having unfavorable scores ranged from 0.4 to 0.5, NS). CONCLUSIONS - Perceived treatment burden and positive effect are unfavorably affected by random allocation to a strict target level for glycemic control. Improved glycemic control is associated with favorable mood and possibly general well-being in type 2 diabetes

Связи изменений среднемесячных ОСО над Антарктикой и площади теплого тропического бассейна Тихого океана при современном потеплении климата

Объектом данного исследования выбраны изменения распределения среднемесячных значений ОСО над Антарктикой, а также площади ТТБ в западном полушарии. Предметом исследования есть изменения статистических связей между указанными процессами, происходившими за период современного потепления климата. Целью работы есть выявление их связей, которые на протяжении периода современного потепления климата усиливались устойчиво и ныне являются значимыми