Scientists of the Institute of Health Economics and Health Care Management (IGM) and of the Institute of Epidemiology II (EPI II) at Helmholtz Zentrum München (HMGU), together with colleagues of the German Diabetes Center (DDZ) in Düsseldorf, investigated the association between self-management behavior and mortality in patients with type 2 diabetes. HMGU and the DDZ are partners in the German Center for Diabetes Research (DZD).
High self-management index – low mortality
340 study participants with type 2 diabetes were interviewed with regard to their patient behavior – e.g. regular monitoring of blood glucose levels, having a diet plan or performing physical exercise. Based on this data a self-management index was defined. The team led by Professor Rolf Holle and Michael Laxy correlated the index with the mortality of the participants, who were monitored over a period of 12 years. The analysis showed that patients with good diabetes self-management, that is patients with a high self-management index, had a significantly lower mortality risk than patients with a low self-management index. This association exists independent of other factors that can influence mortality, such as age, sex, comorbidities or medication.
Active participation of the patient in the treatment is important
"The results show that in addition to physician delivered treatment according to medical guidelines, the patient's behavior is also of great significance for the course of the disease and for the success of the treatment process ", said Holle, group leader of the research group Economic Evaluation at the IGM. "Patient-centered services, such as diabetes education, self-management training and information services therefore make a valuable contribution to good patient care and should continue to be expanded."
The basis of the analyzed data is the KORA*-A study, which is composed of participants of two previous population-based health surveys and of the KORA Myocardial Infarction Registry from the Augsburg area.
Diabetes affects nearly ten percent of the population in Germany. The aim of Helmholtz Zentrum München is to develop new approaches to diagnosis, treatment and prevention of common diseases.
* For more than 20 years, the research platform Cooperative Health Research in the Augsburg Region (KORA) has been collecting and analyzing data on the health of thousands of people living in the Augsburg region. The objective is to elucidate the effects of environmental factors, behavior and genes. KORA focuses on the development and course of chronic diseases, in particular myocardial infarction and diabetes mellitus. Risk factors are analyzed with regard to individual health behavior (e.g. smoking, diet, exercise), environmental factors (e.g. air pollution, noise) and genetics. From the perspective of health care research, questions regarding the utilization of health care resources and the cost of health care are also studied.
Laxy, M. et al. (2014), The Association Between Patient-Reported Self-Management Behavior, Intermediate Clinical Outcomes, and Mortality in Patients With Type 2 Diabetes: Results From the KORA-A Study, Diabetes care, doi: 10.2337/dc13-2533
Link to publication: http://care.diabetesjournals.org/content/early/2014/03/13/dc13-2533.abstract
The Helmholtz Zentrum München, the German Research Center for Environmental Health, pursues the goal of developing personalized medicine, i.e. a customized approach to the diagnosis, treatment and prevention of widespread diseases such as diabetes mellitus and lung disease. To that end, it investigates the interaction of genetics, environmental factors and lifestyle. The Helmholtz Zentrum München is headquartered in Neuherberg in the north of Munich. It has about 2,200 staff members and is a member of the Helmholtz Association, Germany's largest scientific organization, a community of 18 scientific-technical and medical-biological research centers with some 34,000 staff members. The Helmholtz Zentrum München is a partner in the German Center for Diabetes Research. http://www.helmholtz-muenchen.de/index.html
The German Center for Diabetes Research e.V. brings together experts in the field of diabetes research and combines basic research, epidemiology and clinical applications. The members of the association are the German Diabetes Center (DDZ) in Düsseldorf, the German Institute of Human Nutrition (DifE) in Potsdam-Rehbrücke, the Helmholtz Zentrum München – the German Research Center for Environmental Health, the Paul Langerhans Institutes of the Carl Gustav Carus University Hospital in Dresden and the Eberhard Karl University of Tübingen as well as the Gottfried Wilhelm Leibniz Research Association and the Helmholtz Association of German Research Centers. The aim of the DZD is to find answers to unsolved questions in diabetes research by adopting a novel, integrative approach and to make a significant contribution towards improving the prevention, diagnosis and treatment of diabetes mellitus. http://www.diabetesforschung.com/index.html
The Institute of Health Economics and Health Care Management (IGM) examines approaches to improving the effectiveness and efficiency of health care. The health care system faces the challenge of delivering high-quality, economically viable medical services to meet the needs of the population. Rapid advances in medical technology and fast-changing demographics further aggravate this problem. A firmly based evaluation of the effectiveness and efficiency of health care structures and processes is therefore an essential prerequisite for a rational health care policy. http://www.helmholtz-muenchen.de/igm/index.html
The Institute of Epidemiology II (EPI II) focuses on the assessment of environmental and lifestyle risk factors which jointly affect major chronic diseases such as diabetes, heart disease and mental health. Research builds on the unique resources of the KORA cohort, the KORA myocardial infarction registry, and the KORA aerosol measurement station. Aging-related phenotypes have been added to the KORA research portfolio within the frame of the Research Consortium KORA-Age. The institute's contributions are specifically relevant for the population as modifiable personal risk factors are being researched that could be influenced by the individual or by improving legislation for the protection of public health. http://www.helmholtz-muenchen.de/epi2/index.html
Prof. Rolf Holle, Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764 Neuherberg, Germany, Tel. +49 89-3187-4192 - E-Mail: firstname.lastname@example.org
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