As a society, we need to do the hard work of sorting out what constitutes a pattern of worsening mental health.
25 Accordingly, patients exhibiting the pattern of worsening glycemic control when exposed to intensive treatment should be set at higher glucose targets (Table 3).
An alternative possibility, that patients delayed visits to work on lifestyle changes, is not supported by the pattern of worsening A1C values in the intervention groups.
However, a common pattern of worsening wellbeing was found with declining physical function, and maximising function within a clinical approach of palliation is essential to enhance patient outcomes.
However, to date the trajectories of β-cell function and glycemic control suggest that regardless of differences in early effects, an underlying pattern of worsening β-cell function persists.
There was an emerging pattern of worsening clinical neuropathy scores associated with an increasing proportion of patients with more severe painful neuropathic symptoms (P < 0.0001), and there was a significant, positive correlation between NSS and NDS (r = 0.24, P < 0.0001).
The pattern of worsening glycemia which occurred after an initial improvement in glucose control (based on comparison of eAG0 with baseline A1C) and coincided with a reduction over time in screen views might have been due to participant burnout or stress.
The mean HbA1c values did not follow the pattern of worsening from group A to group D to group C, but they were significantly higher in the group D subjects (8.9 ± 2.3% [74 ± 25.1 mmol/mol]) than in group A and group C subjects (7.7 ± 1.4% [61 ± 15.3 mmol/mol] and 7.5 ± 1.3% [58 ± 14.2 mmol/mol]; P = 0.003).
However, in spite of the statistically, relatively small decline, the trend is negative over time with a consistent pattern of generally worsening sleep quality or insufficient recovery.
In a study by Hiltunen et al. (3), a pattern of general worsening of HRF across categories of glucose tolerance status was evident.
