This systematic review found robust data demonstrating that engagement in diabetes self-management education results in a statistically significant decrease in A1C levels .
PRACTICE IMPLICATION S The data suggest mode of delivery , hours of engagement , and baseline A1C can affect the likelihood of achieving statistically significant and clinical ly meaningful improvement in A1C
OBJECTIVE Assess effect of diabetes self-management education and support methods , providers , duration , and contact time on glycemic control in adults with type 2 diabetes .
The effect of motivational interviewing on glycaemic control and perceived competence of diabetes self-management in patients with type 1 and type 2 diabetes mellitus after attending a group education programme: a randomised controlled trial
Aims /hypothesisThe aim of this study was to measure the efficacy of motivational interviewing ( MI ) compared with usual care on changes in glycaemic control and competence of diabetes self-management in patients with diabetes mellitus . Methods Patients were eligible if they had type 1 or 2 diabetes mellitus , were over 18 years of age and had participated in a 4 day group education programme offered at a diabetes clinic at a university hospital in Denmark . Exclusion criteria included pregnancy , severe debilitating disease and cognitive deficit . Out of 469 patients who attended the group education programme , 349 patients were r and omised to either a usual care control group or an intervention group , which received up to five individual counselling sessions in 1 year based on MI , in addition to usual care . A r and omised parallel design was used and open-label allocation was done by r and om permuted blocks , with allocation concealment by sequentially numbered , sealed , opaque envelopes . The primary outcome was glycated haemoglobin ( HbA1c ) . Analysis regarding measurements of glycated haemoglobin ( HbA1c ) and competence of self-management ( using the Problem Areas in Diabetes Scale [ PAID ] and Perceived Competence for Diabetes Scale [ PCDS ] ) was based on 298 participants followed for a 24 month period . Data were collected at the Department of Endocrinology at Odense University Hospital . Our hypotheses were that MI could : ( 1 ) reduce HbA1c levels ; ( 2 ) increase self-efficacy ; and ( 3 ) increase diabetes self-care , compared with usual care . Results Out of the 176 included in the control group and 173 in the intervention group , 153 and 145 were analysed in the groups , respectively . When using the baseline value as covariate there were no significant differences in change score between the two study groups with regard to mean level of HbA1c ( 0.131 , p = 0.221 ) , PAID scores ( −1.793 , p = 0.191 ) or PCDS scores ( 0.017 , p = 0.903 ) at the 24 month follow-up , using a mixed effects regression model . The patients in the intervention group showed significantly higher levels of perceived competence in dealing with diabetes compared with the control group ( mean change score = −0.387 , p = 0.002 ) following 1 year of intervention . Conclusion /interpretationWe were unable to demonstrate any benefit , over or above usual care , of MI in patients with diabetes who have just completed a diabetes education programme , and who have well-regulated diabetes . Trial registration Clinical Trials NCT00555854 . Funding The National Board of Health , Funen County , Danish Association of Diabetes , Odense University Hospital , University of Southern Denmark and TRYG Fonden
This systematic review found robust data demonstrating that engagement in diabetes self-management education results in a statistically significant decrease in A1C levels .
PRACTICE IMPLICATION S The data suggest mode of delivery , hours of engagement , and baseline A1C can affect the likelihood of achieving statistically significant and clinical ly meaningful improvement in A1C
OBJECTIVE Assess effect of diabetes self-management education and support methods , providers , duration , and contact time on glycemic control in adults with type 2 diabetes .