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 .
Prospective Randomized Controlled Trial to Evaluate Effectiveness of Registered Dietitian–Led Diabetes Management on Glycemic and Diet Control in a Primary Care Setting in Taiwan
OBJECTIVE In this r and omized controlled trial we evaluated the effect of registered dietitian – led management of diabetes on glycemic control and macronutrient intake in type 2 diabetic patients in primary care clinics in Taiwan and studied the association between changes in macronutrient intake and glycemic measures . RESEARCH DESIGN AND METHODS We recruited 154 adult patients with type 2 diabetes and r and omly assigned them to a routine care control group ( n = 79 ) or a registered dietitian – led intervention group ( n = 75 ) who received on-site diabetic self-management education every 3 months over 12 months . RESULTS Over the 1-year period , neither the intervention group ( n = 75 ) nor the control group ( n = 79 ) had significant changes in A1C , whereas the intervention patients with poorly controlled baseline A1C ( ≥7 % ) ( n = 56 ) had significantly greater improvements in A1C and fasting plasma glucose than the control subjects ( n = 60 ) ( −0.7 vs. −0.2 % , P = 0.034 ; −13.4 vs. 16.9 mg/dl , P = 0.007 ) during the same period . We also found significant net intervention-control group differences in overall energy intake ( −229.06 ± 309.16 vs. 56.10 ± 309.41 kcal/day ) and carbohydrate intake ( −31.24 ± 61.53 vs. 7.15 ± 54.09 g/day ) ( P < 0.001 ) in patients with poorly controlled A1C . Multivariable adjusted modeling revealed an independent association between changes in carbohydrate intake and A1C in the intervention group ( n = 56 ; β = 0.10 , SEM = 0.033 , P = 0.004 ) . CONCLUSIONS On-site registered dietitian – led management of diabetes can improve glycemic control in patients with poorly managed type 2 diabetes in primary care clinics in Taiwan . A reduction in carbohydrate intake may improve glycemic status
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 .