Featured Research

from universities, journals, and other organizations

Behavioral and educational interventions appear to be effective for patients with poorly controlled diabetes

Date:
October 11, 2011
Source:
JAMA and Archives Journals
Summary:
Three randomized controlled trials examine the effectiveness of behavioral and educational interventions for patients with poorly controlled diabetes.

Three randomized controlled trials published Online First in Archives of Internal Medicine examine the effectiveness of behavioral and educational interventions for patients with poorly controlled diabetes. All three reports are part of the journal's Health Care Reform series.

In one report, Katie Weinger, Ed.D., of the Joslin Diabetes Center, Boston, and colleagues, evaluated the efficacy of a behavioral intervention for improving glycemic control among patients with long-duration poorly controlled diabetes. The trial randomized 222 adults with diabetes to three treatment groups: structured behavioral treatment (included a five-session manual-based, educator-led structural intervention with cognitive behavioral strategies), group attention control (educator-led attention control group education program) and individual control (unlimited individual nurse and dietitian education sessions for six months).

The authors found that all participants, regardless of treatment group, showed glycemic improvement, however the structured behavioral group showed greater improvements compared to the other two treatment groups. Additionally, participants with type 2 diabetes showed greater improvement than patients with type 1 diabetes. Quality of life, number of daily glucose meter checks and frequency of diabetes self-care did not differ by type of intervention over time; however, patients with type 2 diabetes showed higher quality of life scores than patients with type 1. The authors concluded that, "a structured, cognitive behavioral program is more effective than two control interventions in improving glycemia in adults with long-duration diabetes."

In a second report, JoAnn Sperl-Hillen, M.D., of HealthPartners Research Foundation and HealthPartners Medical Group, Minneapolis, and colleagues evaluated a total of 623 adults from Minnesota and New Mexico with type 2 diabetes and glycosylated hemoglobin (HbA1c) concentrations of 7 percent or higher. Participants were randomized to receive either group education, individual education or usual care (no assigned education; control group).

The authors found that individual education resulted in better glucose control in patients with established suboptimally controlled diabetes than did group education. Although mean (average) HbA1c concentrations decreased across all treatment groups, levels decreased significantly more in the individual education group (-0.51 percent) when compared with the group education (-0.27 percent) and the usual care (-0.24 percent) groups. Participants in the individual education group also were more likely to have HbA1c levels at or below 7 percent than participants in either the group education or usual care treatments. "In conclusion, among patients with type 2 diabetes of relatively long duration and HbA1c levels of 7 percent or higher, short-term glucose control improved more in those receiving individual diabetes education than in those receiving group diabetes education or assigned to no education," the authors write.

A third study, conducted by Dominick L. Frosch, Ph.D., of the Palo Alto Medical Foundation Research Institute, Palo Alto, Calif., and colleagues examined the effectiveness of disease management programs among socially and economically disadvantaged patients with poorly controlled diabetes. The study included 201 patients (72 percent African American or Latino; 74 percent with annual incomes of less than or equal to $15,000) with poorly controlled diabetes. Participants were randomized to receive either an intervention package consisting of a 24-minute video behavior support intervention with a workbook and five sessions of telephone coaching by a trained diabetes nurse (treatment group), or a 20-page brochure developed by the National Diabetes Education Program (control group).

The authors found that most participants in both the treatment group (94.3 percent) and control group (93.5 percent) had received the assigned treatment materials and the majority (88.5 percent in the treatment group and 89.8 percent in the control group) rated the clarity of the information presented as good, very good, or excellent at the one-month follow-up. Across treatment groups there was a significant overall reduction in mean (average) HbA1c levels from study initiation to six-month follow-up; however differences between the groups were not significant. The authors also found that differences in other clinical measures (including blood lipid levels and blood pressure) and measures of diabetes knowledge and self-care behaviors were also non-significant.

"More intensive and therefore more expensive interventions may be a worthwhile investment to lower the high costs associated with poorly managed diabetes in the long term; however, larger structural interventions also may be necessary to overcome the many challenges faced by these severely disadvantaged patients," the authors conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Katie Weinger; Elizabeth A. Beverly; Yishan Lee; Lilya Sitnokov; Om P. Ganda; A. Enrique Caballero. The Effect of a Structured Behavioral Intervention on Poorly Controlled Diabetes: A Randomized Controlled Trial. Archives of Internal Medicine, 2011; DOI: 10.1001/archinternmed.2011.502
  2. JoAnn Sperl-Hillen; Sarah Beaton; Omar Fernandes; Ann Von Worley; Gabriela Vazquez-Benitez; Emily Parker; Ann Hanson; Jodi Lavin-Tompkins; Patricia Glasrud; Herbert Davis; Kenneth Adams; William Parsons; C. Victor Spain. Comparative Effectiveness of Patient Education Methods for Type 2 Diabetes: A Randomized Controlled Trial. Archives of Internal Medicine, 2011; DOI: 10.1001/archinternmed.2011.507
  3. Dominick L. Frosch; Visith Uy; Socorro Ochoa; Carol M. Mangione. Evaluation of a Behavior Support Intervention for Patients With Poorly Controlled Diabetes. Archives of Internal Medicine, 2011; DOI: 10.1001/archinternmed.2011.497

Cite This Page:

JAMA and Archives Journals. "Behavioral and educational interventions appear to be effective for patients with poorly controlled diabetes." ScienceDaily. ScienceDaily, 11 October 2011. <www.sciencedaily.com/releases/2011/10/111010173021.htm>.
JAMA and Archives Journals. (2011, October 11). Behavioral and educational interventions appear to be effective for patients with poorly controlled diabetes. ScienceDaily. Retrieved October 23, 2014 from www.sciencedaily.com/releases/2011/10/111010173021.htm
JAMA and Archives Journals. "Behavioral and educational interventions appear to be effective for patients with poorly controlled diabetes." ScienceDaily. www.sciencedaily.com/releases/2011/10/111010173021.htm (accessed October 23, 2014).

Share This



More Health & Medicine News

Thursday, October 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
Powered by NewsLook.com
U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

Newsy (Oct. 22, 2014) Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
Powered by NewsLook.com
US to Track Everyone Coming from Ebola Nations

US to Track Everyone Coming from Ebola Nations

AP (Oct. 22, 2014) Stepping up their vigilance against Ebola, federal authorities said Wednesday that everyone traveling into the US from Ebola-stricken nations will be monitored for symptoms for 21 days. (Oct. 22) Video provided by AP
Powered by NewsLook.com
Doctors Help Paralysed Man Walk Again, Patient in Disbelief

Doctors Help Paralysed Man Walk Again, Patient in Disbelief

AFP (Oct. 22, 2014) Polish doctors describe how they helped a paralysed man walk again, with the patient in disbelief at the return of sensation to his legs. Duration: 1:04 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins