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1.  DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol 
Background
The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management.
Methods and design
The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed.
Discussion
The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel) study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management.
Trial Registration
Protocol NCT00325624
doi:10.1186/1472-6823-9-13
PMCID: PMC2689225  PMID: 19426530
2.  Serum Lp(a) in diabetics with and without evidence of clinical nephropathy—A preliminary study 
Type 2 diabetes is associated with a marked increase in the risk of coronary artery disease. Dyslipidaemia is believed to be a major cause of this increased risk. Recently, elevated levels of lipoprotein (a), Lp(a), have been reported to be associated with an increased risk. However there is very little data regarding Lp(a) concentrations and type 2 diabetes from India. The objective of the study was to assess serum Lp(a) levels in type 2 diabetics with and with out evidence of clinical nephropathy. We estimated serum Lp(a) levels in 30 control subjects, 30 diabetics without evidence of clinical nephropathy and 30 diabetics with evidence of clinical nephropathy. Statistical analysis showed that Lp(a) levels were increased in diabetic patients with nephropathy (mean 46.3±17.6 mg/dl). The Lp(a) levels however did not differ significantly between control (mean 20.2±15.9 mg/dl) and diabetics without nephropathy (mean 22.6±13.1mg/dl). Thus diabetes per se seems to have little or no influence on serum Lp(a) levels, however elevated levels were seen in patients with nephropathy.
doi:10.1007/BF02867941
PMCID: PMC3453725  PMID: 23105336
Diabetes; nephropathy; Lp(a); plasminogen; and atherosclerosis

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