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 .
Evaluation of a behavior support intervention for patients with poorly controlled diabetes.
BACKGROUND Disease management programs that include ongoing telephone support for patients with diabetes have shown promise , but published studies have enrolled few socially and economically disadvantaged patients . METHODS We conducted a r and omized controlled trial with 201 patients with poorly controlled type 2 diabetes mellitus ( 72 % African American or Latino ; 74 % with incomes of ≤$15,000 ) . Participants were r and omized to an intervention package consisting of a 24-minute video behavior support intervention with a workbook and 5 sessions of telephone coaching by a trained diabetes nurse or a 20-page brochure developed by the National Diabetes Education Program . Study measures were completed at baseline , 1 month , and 6 months . Participants ' review of the intervention material s was assessed at 1 month . The primary trial end point was hemoglobin A(1c ) value . Secondary end points included lipid levels , blood pressure , diabetes knowledge , and self-care behaviors . Data were analyzed with repeated measures analysis of variance . RESULTS Most participants in both groups ( 94 % ) review ed the intervention provided , and 73 % of participants assigned to the experimental group completed 5 sessions of telephone coaching . There was a significant overall reduction in mean ( SD ) hemoglobin A(1c ) value from baseline ( 9.6 % [ 2.0 % ] ) to 6 months ( 9.1 % [ 1.9 % ] ) ( P < .001 ) , but differences between groups were nonsignificant . Differences on other clinical measures ( lipid levels and blood pressure ) and measures of diabetes knowledge and self-care behaviors were also nonsignificant . CONCLUSIONS There was no significant effect of the experimental intervention compared with the control condition . The dose of intervention provided was less than in previously published studies . More intensive interventions may be necessary for the most disadvantaged patients . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00668590
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 .