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At least 811 records · Page 45Linked to original sources
PubMed2005

Achievement of English National Service Framework lipid-lowering goals: pooled data from recent comparative treatment trials of statins at starting doses.

Despite the importance of reducing cardiovascular disease (CVD) risk, detailed in guidelines in many countries, repeated surveys show poor physician performance in attaining guideline lipid targets, which is associated with reluctance by physicians to up-titrate statins from starting doses. Data from randomised, double-blind trials comparing common starting doses of atorvastatin, pravastatin, rosuvastatin and simvastatin for 12 weeks in hypercholesterolaemic patients were therefore analysed for achievement of lipid-lowering goals recommended by the England National Service Framework (NSF) for coronary heart disease (CHD). In three pooled trials, rosuvastatin 10 mg (n = 389) reduced low-density lipoprotein cholesterol (LDL-C) and total cholesterol more significantly than atorvastatin 10 mg (n = 393) (p < 0.001). NSF goals were achieved by 83% of rosuvastatin patients vs. 55% of atorvastatin patients (p < 0.001) at relevant starting doses. In two pooled trials, rosuvastatin 10 mg (n = 226) reduced LDL-C and total cholesterol more significantly than simvastatin 20 mg (n = 249) and pravastatin 20 mg (n = 252) (p < 0.001). NSF goals were achieved at starting doses by 83% of rosuvastatin patients vs. 51% of simvastatin patients and 19% of pravastatin patients (p < 0.001 vs. each comparator). This improved achievement of NSF lipid target, at starting doses, was also seen in high-risk patients (those eligible for secondary prevention or primary prevention because of a 10-year CVD risk of >30%) with 84% patients on rosuvastatin vs. 58% on atorvastatin and 75% of patients on rosuvastatin vs. 49% on simvaststin and 24% on pravastatin. In summary, there are considerable and clinically significant variations in the achievement of lipid goals between common starting doses of statins in hypercholesterolaemic patients.

Adult↗
PubMed1989

Oral health of Polish children and WHO/FDI goals for the year 2000.

Based on available epidemiology data, dating sporadically from 1967 to 1985, of the oral health situation of Polish children and youngsters, the attainment of the first three oral health goals of FDI/WHO for the year 2000 is discussed. It can be assumed that the first oral health goal may be reached by at most only 10% of Polish children. The second oral health goal may be achieved by some 60% of 12-yr-old Polish children. The third oral health goal will be reached by at most 33% of 18-yr-old Polish youngsters. The reasons for these rather pessimistic prognoses are explained.

Adolescent↗
PubMed1994

Fat intake: implications of changes in distribution for setting dietary goals in the UK.

STUDY OBJECTIVE: To examine (a) changes in the shape of the distribution of dietary fat intake as the mean dietary fat intake of the population shifts and (b) implications for setting national dietary goals. DESIGN: Data on the percentage of energy from total fat, saturates, monounsaturates, polyunsaturates, and the P:S ratio were analysed for two dietary intervention trials and six cross sectional dietary surveys. The nutrient distributions from each study were described in terms of the mean, standard deviation (SD), coefficient of variation (CV), and skewness statistic. For the intervention trials statistical parameters were compared for groups who received and did not receive dietary advice. For the cross sectional studies, statistical parameters were compared across groups with different levels of mean fat intake. The implications of the results for setting dietary goals were considered using statistical models. MAIN RESULTS: For most fat fractions there was a positive association between the mean and the SD, and an inverse association between the mean and the CV, indicating that as the mean shifts upwards the SD increases but not in proportion to the mean. This is intermediate between a constant SD and a constant CV model. For a population nutrient goal of a maximum of 15% saturates, the estimated population mean for British women would be 8.4% using the constant SD model and 10.8% using the constant CV model. For saturates and the P:S ratio, a lower mean intake was associated with a greater positive skew in the distribution of reported intakes. For saturates, this is consistent with a group of high fat consumers who fail to reduce their intake as the population mean shifts downwards: a "rearguard effect". Findings for the P:S ratio are consistent with a group of consumers who produced a strong positive skew at low mean intakes, which reduced in size as the mean population intake increases: a "vanguard effect". CONCLUSIONS: These findings provide evidence that the distribution of fat intake may change with the mean to a degree that the setting and monitoring of nutritional goals may need to take account of changes in variance and shape of the intake distribution.

Adult↗
PubMed2003

Controlling blood pressure in 50% of all hypertensive patients: an achievable goal in the healthy people 2010 report?

BACKGROUND: One important objective defined in the Healthy People 2010 report was to improve blood pressure (BP) control to < 140/90 mm Hg in 50% of all hypertensive patients. Because the US population is becoming older, more obese, and ethnically diverse, the health and economic benefits of reaching this goal become more valuable each year. Hypertension control rates are currently at approximately 31% of all hypertensives and have risen slowly and erratically since 1988. In the absence of a coordinated strategic plan, achieving this critically important goal for BP control is highly unlikely. METHODS: A selected literature review was undertaken to briefly assess the cardiovascular benefits of controlling hypertension. Greater focus was placed on variables that impact hypertension awareness, treatment, and control. The impact on hypertension control rates of theoretic changes in awareness, treatment, and control individually and collectively was examined. Four categories of potential barriers to optimizing BP control are discussed: systems, provider, patient, and treatment factors. RESULTS: Raising awareness to 80% of all hypertensives, ensuring treatment of 90% of aware hypertensives, and controlling BP to < 140/90 mm Hg in 70% of treated patients would achieve control rates of 50%. CONCLUSIONS: The barriers to achieving the Healthy People 2010 goal of controlling hypertension in 50% of all patients are formidable but appear to be resolvable with a coordinated strategic plan. Given projected demographic changes in the United States, the health and economic benefits of attaining the national goal for hypertension control would seem to merit a serious integrated effort.

Adult↗
PubMed1995

Predictive human pursuit and "orbital goal" of microstimulated smooth eye movements.

1. Anticipatory saccades in smooth pursuit move the point of gaze from near the moving target to well ahead of it, interrupting accurate smooth pursuit. Their effects on the pursuit process were studied in 22 normal human subjects. We presented horizontal periodic target trajectories of 30 degrees amplitude and 30 degrees/s constant velocity or 0.4 Hz sinusoidal velocity in 40-s trials. Saccades and surrounding smooth eye movement (SEM) segments were marked and classified by computer. 2. Anticipatory saccades were often followed by slowed SEM that tended to intercept the target at the endpoint of its trajectory. This was seen in the distribution of projections of the initial 60 ms of postsaccadic SEM to the time of the trajectory endpoint. Magnitude of this SEM tended to follow a function of the time and location of the endpoint of the anticipatory saccade, decreasing as the anticipatory saccades landed closer to the trajectory endpoint. 3. The time and location of the target trajectory endpoint seemed to be the goal for this SEM. We believe this to demonstrate the predictive use of the period and amplitude of the trajectory in smooth pursuit, apart from the instantaneous velocity match of the target. 4. Gottlieb and coworkers in the frontal eye field and Ron and Robinson in the cerebellum produced SEMs in the monkey by microstimulation. At some sites in both structures, direction and velocity of the SEMs depended on the initial position of the eye in that the elicited SEMs appeared to be converging toward a common point, or "orbital goal", and the SEM velocity diminished as the gaze neared that goal.2+ Both our SEM after anticipatory saccades and microstimulated SEM in the monkey slowed as the initial position was brought closer to the inferred orbital goal. This similarity suggests that the goal-directed SEM sites in the monkey might be part of a mechanism for predictive pursuit.

Electrooculography↗
PubMed1986

Analytical goals for glucose analyses.

Analytical goals may be defined as those standards of performance required to facilitate optimal patient care. Review of the considerable amount of published work on glucose analyses allows delineation of the following current goals: For plasma glucose: within-laboratory between-batch imprecision--CV less than or equal to 2.2%; inaccuracy - no bias; linearity - 1 to 28 mmol/L; detection limit - 1 mmol/L; turnaround time - 30 min (in emergency situations). For urine glucose (quantitative): within-laboratory between-batch imprecision - SD less than or equal to 0.1 mmol/L; inaccuracy - no bias. For urine glucose (qualitative or semi-quantitative): negative - should be negative; positive - should be positive +/- one positive colour block; detection limit - 2.8 mmol/L. Moreover, each laboratory should develop goals for the many pre-analytical factors affecting glucose analyses. While the above goals are not always achieved in current practice, they are attainable and are worthy targets to strive to reach. The general principles discussed here for glucose analyses are applicable to other analytes of interest to the clinical biochemist.

Blood Glucose↗
PubMed1991

A comparison of analytical goals for haemoglobin A1c assays derived using different strategies.

Analytical goals for the performance characteristics of assays of haemoglobin A1c (HbA1c) have been investigated using different assumptions for generation of estimates, these being based on strategies using data on biological variation and on the clinical use of results. The derived goals are highly dependent on the assumptions made. In general, in monitoring of patients (using results from the same laboratory), the analytical imprecision is the most demanding, whereas bias (inaccuracy) is the most important characteristic when strategies for several centres (laboratories) to achieve similar results are invoked. Goals for analytical quality should be given in a form in which both analytical imprecision and bias (or systematic error) are specified. When several goals are to be considered (for different relevant assumptions), the most demanding should be used.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

Patient perceptions of diabetes treatment goals.

The current treatment of type II noninsulin dependent diabetes mellitus (NIDDM) and obesity involves complex regimens for weight reduction and improvement in metabolic control that necessitate active participation by the patient in establishing treatment goals and strategies. However, well-documented rates of nonadherence suggest that weaknesses may exist in patient-provider communications that preclude such patient participation. This study examines patient perceptions of diabetes treatment goals as established with their health care providers. Fifty-four individuals with type II NIDDM and obesity were surveyed. To determine the degree of congruence between patient and health care provider, the physicians of study participants were also surveyed. A 53% discrepancy rate was found to exist in the area of overall treatment goals. In addition, a 57% and 43% rate of discrepancy was found for the specific goals of weight loss and blood glucose levels, respectively. Further findings and the implications for practice are discussed in this paper.

Adult↗
PubMed2003

Comparison of the efficacy of rosuvastatin versus atorvastatin, simvastatin, and pravastatin in achieving lipid goals: results from the STELLAR trial.

In the Statin Therapies for Elevated Lipid Levels compared Across doses to Rosuvastatin (STELLAR) trial, the efficacy of rosuvastatin calcium (Crestor) was compared with that of atorvastatin (Lipitor), simvastatin (Zocor), and pravastatin (Pravachol) for lowering plasma low-density lipoprotein cholesterol (LDL-C) after 6 weeks of treatment. In this multicenter, parallel-group, open-label trial, adults with hypercholesterolemia were randomized to treatments with rosuvastatin 10, 20, 40, or 80 mg, atorvastatin 10, 20, 40, or 80 mg, simvastatin 10, 20, 40, or 80 mg, or pravastatin 10, 20, or 40 mg. Efficacy and safety results from this trial have been previously published. The additional analyses included in this report show that 53% (83/156) to 80% (125/157) of patients in the rosuvastatin 10- to 40-mg groups achieved LDL-C levels < 100 mg/dl (< 2.6 mmol/l), compared with 18% (28/158) to 70% (115/165) of patients who received atorvastatin, 8% (13/165) to 53% (86/163) of patients who received simvastatin, and 1% (1/160) to 8% (13/161) of patients who received pravastatin. Other additional analyses showed that more patients in the rosuvastatin 10- to 40-mg groups than in the comparator groups who were at high risk of coronary heart disease according to National Cholesterol Education Program Adult Treatment Panel (ATP) III, Joint European Societies, or Canadian guidelines achieved the LDL-C goals of < 100 mg/dl (< 2.6 mmol/l) (55% to 77% compared with 0 to 64%), < 3.0 mmol/l (< 116 mg/dl) (76% to 94% compared with 6% to 81%), and < 2.5 mmol/l (< 97 mg/dl) (47% to 69% compared with 0 to 53%), respectively. Results favoring rosuvastatin versus the comparators were also reported for patients: (a) who had triglycerides > or = 200mg/dl (> or = 2.3 mmol/l), and achieved both ATP III LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C) goals (80% to 84% versus 15% to 84%); (b) overall who achieved the Canadian LDL-C goals of < 2.5 (< 97 mg/dl) to < 5.0 mmol/l (< 193 mg/dl) (85% to 91% versus 44% to 86%); and (c) who achieved all 3 Canadian goals for LDL-C, triglycerides (< 3.0 mmol/l [< 266 mg/dl] to < 2.0 mmol/l [< 177 mg/dl]), and the total cholesterol/high-density lipoproteincholesterol ratio (< 4 to < 7) (70% to 83% versus 35% to 79%).

Anticholesteremic Agents↗
PubMed2004

Effect of raloxifene on the incidence of elevated low density lipoprotein (LDL) and achievement of LDL target goals in postmenopausal women.

OBJECTIVE: To determine the extent to which raloxifene can maintain low density lipoprotein cholesterol (LDL-C) levels below 160 mg/dL or reduce elevated LDL-C levels to below lipid-lowering goals in postmenopausal women. PATIENTS AND METHODS: The Multiple Outcomes of Raloxifene Evaluation (MORE) osteoporosis treatment trial randomized 7705 postmenopausal women to placebo or raloxifene (60 mg or 120 mg) daily for a core treatment phase of 3 years. Changes in LDL-C and other serum lipids in a subset of women was a predefined secondary objective. This post-hoc analysis included the 2413 women who did not take lipid-lowering medications at any time during the trial and for whom LDL-C measurements were available. The threshold for high LDL-C (> or = 160 mg/dL) and LDL-C lipid-lowering goals were defined according to National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) guidelines. RESULTS: The percent of women with LDL-C < 160 mg/dL was comparable between treatment groups at baseline (placebo, 57.5%; raloxifene 60 mg, 56.4%; raloxifene 120 mg, 56.8%). At 3 years, the percent of these women whose LDL-C had increased to above 160 mg/dL was significantly less in the raloxifene 60 mg and 120 mg groups compared with placebo by 65% (95% CI, 44%-78%) and 64% (95% CI, 43%-77%), respectively. Among women with elevated (defined for these analyses as > or = 160 mg/dL) LDL-C at baseline, the proportion having elevated LDL-C at 3 years was significantly less in the raloxifene 60 mg and 120 mg groups compared with placebo by 32% (95% CI, 24%-40%) and 40% (95% CI, 32%-48%), respectively. Fifty percent and 13% of these women achieved LDL-C goals of < 160 mg/dL and < 130 mg/dL, respectively (P < 0.001 vs. placebo for both) in the raloxifene 60 mg group, with similar results for the raloxifene 120 mg group. CONCLUSIONS: In postmenopausal women with osteoporosis not taking concurrent lipid-lowering therapy, raloxifene significantly reduced the incidence of LDL-C > or = 160 mg/dL and significantly increased the proportion achieving LDL-C goals for lipid-lowering compared with placebo. Whether these and other effects of raloxifene on cardiovascular risk markers will improve cardiovascular outcomes requires further study.

Aged↗
PubMed1983

Cathectic orientation, goal setting and mood.

Investigated the reliability and validity of a new verbal cathexis test, based on objectively scored achievement data. Criteria were based on interviews about goal orientations and mood ratings, performed three times a day for a week. Goals were scored analogously with the cathexis test, viz. in the three dimensions hetero-homo, active-passive, and positive-negative. Average mood scores and mood variabilities were estimated. The Oedipal and combined cathexis adjustment indices correlated with goal ratings. Moods correlated with cathectic balance indices. Strong correlations were found to exist between average moods and goal ratings in both active-passive and positive-negative dimensions, as well as sex differences in mood variability and Oedipal orientation as measured by the cathexis test.

Journal Article↗
PubMed1996

Insect navigation en route to the goal: multiple strategies for the use of landmarks

There are at least four distinct ways in which familiar landmarks aid an insect on its trips between nest and foraging site. Recognising scenes: when bees are displaced unexpectedly from their hive to one of several familiar locations, they are able to head in the direction of home as though they had previously linked an appropriate directional vector to a view of the scene at the release site. Biased detours: ants recognise familiar landmarks en route and will correct their path by steering consistently to the left or to the right around them. Aiming at beacons: bees and ants also guide their path by approaching familiar landmarks lying on or close to the direct line between start and finish. Simulations suggest that such mechanisms acting together may suffice to account for the routes taken by desert ants through a landmark-strewn environment: the stereotyped trajectories of individual ants can be modelled by a weighted combination of dead reckoning, biased detours and beacon-aiming. These mechanisms guide an insect sufficiently close to an inconspicuous goal for image matching to be successfully employed to locate it. Insects then move until their current retinal image matches a stored view of the surrounding panorama seen from a vantage point close to the goal. Bees and wasps perform learning flights on their first departure from a site to which they will return. These flights seem to be designed to pick up the information needed for several navigational strategies. Thus, a large portion of the learning flight of a bee leaving a feeder tends to be spent close to the feeder so aiding the acquisition of a view from that vantage point, as is needed for image matching. Bees and social wasps also tend to inspect their surroundings while facing along preferred directions and to adopt similar bearings before landing, thereby making it easy to employ retinotopically stored patterns in image matching. Aiming at beacons, in contrast, requires a landmark to be familiar to the frontal retina. Objects tend to be viewed frontally while the insect circles through arcs centred on the goal. This procedure may help insects to pick out those objects close to the goal that are best suited for guiding later returns.

Journal Article↗
PubMed1997

Factors associated with achievement of goals for home health care.

With the introduction of Medicare's Prospective Payment System (PPS) and DRGs, the economic value of home health care services lies in its ability to reduce total patient care costs by the substitution of outpatient home care for inpatient hospital care. Analysis of service delivery patterns utilized by home health agencies in meeting goals for patient care will be an important ingredient in meeting these objectives. The purpose of this study was to determine if important patient characteristics known at the onset of home health care are predictive of utilization of home health services and/or the likelihood of meeting goals for home care established at the time of certification of care. Multivariate models were developed which predicted the odds of terminating with goals met based upon age, intensity of utilization, functional limitations, prognosis, presence of a caregiver, and type of patient condition. Results indicated that variability in likelihood of meeting goals for care is much better predicted by patient characteristics than by utilization of home care services.

Health Care Costs↗
PubMed2005

Maintaining cerebral perfusion pressure is a worthy clinical goal.

Cerebral perfusion pressure (CPP) is one aspect of an all-encompassing approach in the management of traumatic brain injury (TBI). The clinical use of CPP is based on theoretical considerations that optimal cerebral blood flow is necessary to meet the metabolic needs of the injured brain. The goal is to preserve the ischemic penumbra and avoid secondary insults. Unfortunately, lack of objective measures of local tissue response and randomized controlled clinical trials prevents confirmation that these goals are being met when actively treating CPP. The present recommended threshold CPP for intervention in the literature is 70 mmHg. However, this specific CPP level is being challenged. There is increasing evidence that this and higher CPP thresholds are not necessary and that a lower CPP may be as clinically effective. There are clinical prospective, but not randomized, human trials showing that CPP 60 to 70 mmHg may be reasonable. Recently, the Brain Trauma Foundation updated their Web-based recommendation of a lower CPP goal of 60 mmHg. However, the lack of definitive data, such as from a randomized prospective intention-to-treat clinical trials, leaves this goal open to controversy. Therefore, for a variety of reasons, the physician may be most prudent to use the published CPP guideline of 70 mmHg until a consensus statement is published advocating a different value.

Blood Pressure↗
PubMed1997

Acceptability of the controlled-drinking goal among alcohol treatment agencies in New South Wales, Australia.

OBJECTIVE: A survey was conducted to estimate the acceptability of the controlled drinking goal among treatment services in New South Wales (NSW), Australia, and to compare results with similar surveys carried out elsewhere. METHOD: Of all identified alcohol treatment services (N = 295) in NSW, 179 (61%) responded to a mailed questionnaire with useable returns. RESULTS: Nearly three-quarters of respondents endorsed controlled drinking but half of these reported allocating less than 25% of their clients to this goal. Community-based services and alcohol treatment units were significantly more likely to endorse controlled drinking than were residential or private facilities. Community-based services and alcohol treatment units were also more likely to base the appropriateness of controlled drinking on professional experience and research evidence, whereas residential and private facilities relied more on the disease model or agency policy in making this determination. Respondents with tertiary qualifications were more likely to endorse controlled drinking than those without such qualifications, and these respondents were more likely to be found in community-based services and alcohol treatment units. CONCLUSIONS: The results show widespread support for the controlled drinking goal among NSW alcohol treatment services. This is similar to the reported status of controlled drinking in Britain and Norway and stands in marked contrast to the comparative reluctance of treatment services in North America to endorse the controlled drinking goal.

Alcohol Drinking↗
PubMed2005

Cancer proteomics: many technologies, one goal.

A major goal of the National Cancer Institute is to alleviate patient pain, suffering and death associated with cancer by the year 2015. This goal does not insinuate a cure for cancer, but rather the development of diagnostics and therapeutics that will eventually decrease cancer morbidity and mortality. A part of meeting this goal is to leverage the enormous data-gathering capabilities of proteomic technologies to discover disease-specific biomarkers in serum, plasma, urine, tissues and other biologic samples. The rapid advance in available technologies that have been spurred by the -omics era, has enabled biologic samples to be surveyed for biomarkers in ways never before possible. However, it is not yet clear which specific technologies will be the most successful. Therefore, proteomic laboratories within the National Cancer Institute are taking a multipronged approach to identify disease-specific biomarkers. This review discusses some of these approaches in their context of meeting the National Cancer Institute's 2015 goal.

Animals↗
PubMedDate not supplied

Cost-effectiveness analysis of simvastatin and lovastatin/extended- release niacin to achieve LDL and HDL goal using NHANES data.

OBJECTIVE: The Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Adult Treatment Panel III (ATP III) encouraged reduced low-density lipoprotein (LDL) cholesterol levels for a greater number of patients and reemphasized the benefits of high-density lipoprotein (HDL) cholesterol. The purpose of this study was to compare 2 regimens achieving simultaneous LDL and HDL goals. METHODS: A decision-analytic model compared the cost-effectiveness of simvastatin and lovastatin/extended-release niacin. The perspective of the analysis was that of a health system. Product labeling was used to determine changes in cholesterol concentrations and frequencies of clinically important adverse events. The Third National Health and Nutrition Examination Survey (NHANES III) adult data were used for baseline cholesterol levels. Each product was titrated to achieve LDL and HDL goals unless an adverse effect occurred. Direct medical costs were determined for each treatment to determine cost-effectiveness. RESULTS: For both the 130 mg/dL and 100 mg/dL LDL goal analyses (and HDL e40 mg/dL), lovastatin/extended-release niacin had higher success rates and lower estimated direct-medical costs than simvastatin. Simvastatin had the highest success rate in achieving LDL level <160 mg/dL and HDL e40 mg/dL; however, its estimated direct-medical cost was approximately twice that of lovastatin/extended-release niacin (665 US dollars versus 333 US dollars). CONCLUSION: For the LDL goals <130 mg/dL and <100 mg/dL (and HDL e40 mg/dL) required of the majority of U.S. residents, lovastatin/extended-release niacin was both more successful and less costly than simvastatin.

Aged↗
PubMed2002

Impact of computer-generated personalized goals on HbA(1c).

OBJECTIVE: The public is increasingly aware of the importance of HbA(1c) testing, yet the vast majority of patients with diabetes do not know their HbA(1c) status or goal. We set forth to evaluate the impact of a system that provides uniquely formatted and personalized reports of diabetes status and goals on changes in HbA(1c) levels. RESEARCH DESIGN AND METHODS: A total of 150 patients with diabetes were randomized to receive either standard care or intervention inclusive of a computer-generated 11" x 17" color poster depicting an individual's HbA(1c) status and goals along with personalized steps to aid in goal achievement. All patients enrolled received diabetes education during the 3 months before enrollment. HbA(1c) was performed at baseline and 6 months. RESULTS: At baseline, there were no significant differences between patient groups in terms of age, sex, education level, race, and HbA(1c) or lipid levels. Among patients with baseline HbA(1c) > or =7.0%, there was an 8.6% (0.77% absolute) reduction in HbA(1c) among control subjects compared with a 17.0% (1.69% absolute) decline in the intervention group (P = 0.032). There were no differences between the control and intervention groups with respect to the frequency of patients experiencing any decline in HbA(1c) (63 vs. 69%, P = 0.87); among these patients experiencing a decline, the most substantial reductions were seen with the control group, which had a 13.3% (1.15% absolute) decline compared with the intervention patients, who reduced their HbA(1c) by 24.2% (2.26% absolute reduction; P = 0.0048). At study close, 77% of the patients had their poster displayed on their refrigerator. CONCLUSIONS: This unique and personalized computer-generated intervention resulted in HbA(1c) lowering comparable to that of hypoglycemic agents.

Biomarkers↗