Wim J. C. de Grauw

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A historical cohort study was performed to assess cardiovascular morbidity and mortality in Type 2 (non-insulin-dependent) diabetic patients. The data were collected from 1967 to 1989 in four Dutch general practices performing the Continuous Morbidity Registration Nijmegen. Each newly diagnosed Type 2 diabetic patient fulfilling the WHO criteria (n = 265)(More)
BACKGROUND Guidelines for type 2 diabetes care in general practice are well known and accepted, but the implementation falls short. OBJECTIVE To implement these guidelines by introducing a diabetes support service (DSS) to support the care delivered by the GP. METHODS A controlled, non-randomised study with delayed intervention in the control group; 78(More)
BACKGROUND Strict glycaemic control in type 2 diabetic patients is recommended in a number of treatment protocols. However, although better glycaemic control prevents or postpones chronic diabetic complications, it remains uncertain how this affects quality of life in the short and long term. AIM To study the impact of insulin therapy on glycaemic control(More)
STUDY OBJECTIVE Control group characteristics as comorbidity and chronic psychosocial problems may play an important part in study outcomes. A primary care data base was used to quantify the effects of varying the case mix of participants. DESIGN Historical cohort study. SETTING Data were collected from 1967-1996 in four Dutch general practices(More)
OBJECTIVE Randomized trials showed that changes in healthcare organization improved diabetes care. This study aimed to identify which organizational determinants were associated with patient outcomes in routine diabetes care. DESIGN Observational study, in which multilevel regression analyses were applied to examine the impact of 12 organizational(More)
To evaluate the Micral test, a semiquantitative dipstick test, in a general practice setting, 317 Type 2 diabetic patients completed a screening for microalbuminuria by means of the Micral test as well as immuno-nephelometry with the Disc 120 immuno-nephelometer (Hyland, Nivelles, Belgium). Data were collected in 10 general practices performing the Nijmegen(More)
OBJECTIVE The determinants of insulin-associated weight gain in type 2 diabetes mellitus (T2DM) are partly unknown. Therefore, we conducted a prospective study to identify predictors of insulin-associated weight gain. RESEARCH DESIGN AND METHODS In patients with T2DM, we assessed physical activity by accelerometry and measured diabetes-related distress by(More)
AIMS To assess the course of microalbuminuria in patients with Type 2 diabetes mellitus in general practice and the predictive value of urinary albumin concentration on all-cause mortality, cardiovascular mortality and cardiovascular morbidity. METHODS Cohort study in Type 2 diabetic patients tested for microalbuminuria in 1992, and re-tested in 1998.(More)
BACKGROUND Early detection and appropriate management of chronic kidney disease (CKD) in primary care are essential to reduce morbidity and mortality. AIM To assess the quality of care (QoC) of CKD in primary healthcare in relation to patient and practice characteristics in order to tailor improvement strategies. DESIGN AND SETTING Retrospective study(More)