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Systematic review and meta-analysis
Quality improvement strategies for diabetes management decrease HbA1c, cholesterol and blood pressure, and increase screening for disease complications
  1. Kelley Newlin Lew
  1. School of Nursing, University of Connecticut, Storrs, Connecticut, USA
  1. Correspondence to : Dr Kelley Newlin Lew
    School of Nursing, University of Connecticut, Nursing, 231 Glenbrook Road Storrs, CT 06269–4026, USA; kelley.newlin_lew{at}

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Implications for practice and research

  • Quality-improvement (QI) strategies improved glycated haemoglobin (HbA1c), low-density lipoprotein (LDL-C), cholesterol (TChol) and blood pressure (BP) levels and increased aspirin and antihypertensive drug use in addition to retinopathy, renal and foot screening compared with usual care.

  • Further research is needed to identify which diabetes interventions, in combination with QI strategies, improve patient outcomes at an acceptable cost to aid health system planning.


Evidence indicates that patients with diabetes mellitus (DM) may achieve improved physiological outcome with preventative and therapeutic interventions. Given the complexities of DM management, such interventions often require coordinated services of primary care physicians, allied health professionals and subspecialists to effectively assist patients with achievement of improved outcomes. Yet, many patients with DM fail to receive such interventions. …

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  • Competing interests None.