Conclusion Based on available literature , evidence suggests that community-based interventions may reduce the incidence rate of T2DM and may positively affect anthropometric indices and HbA1C .
Due to the heterogeneity observed between trials we recommend more well- design ed RCTs with longer follow-up duration s be executed , to confirm whether community-based interventions lead to reduced T2DM events in the at-risk population of LMIC setting
Background The increasing prevalence of type 2 diabetes mellitus ( T2DM ) can have a substantial impact in low- and middle-income countries ( LMICs ) .
Community-based programs addressing diet , physical activity , and health behaviors have shown significant benefits on the prevention and management of T2DM , mainly in high-income countries .
However , their effects on preventing T2DM in the at-risk population of LMICs have not been thoroughly evaluated .
Intensive Patient Education Improves Glycaemic Control in Diabetes Compared to Conventional Education: A Randomised Controlled Trial in a Nigerian Tertiary Care Hospital
Background Diabetes is now a global epidemic , but most cases are now in low- and middle-income countries . Diabetes self-management education ( DSME ) is key to enabling patients to manage their chronic condition and can reduce the occurrence of costly and devastating complications . However , there is limited evidence on the effectiveness of different DSME programmes in re source limited setting s. Methods We conducted an unblinded , parallel-group , individually-r and omised controlled trial at the University of Calabar Teaching Hospital ( Nigeria ) to evaluate whether an intensive and systematic DSME programme , using structured guidelines , improved glycaemic control compared to the existing ad hoc patient education ( clinical practice was unchanged ) . Eligible patients ( ≥18 years , HbA1c > 8.5 % and physically able to participate ) were r and omly allocated by permuted block r and omisation to participate for six months in either an intensive or conventional education group . The primary outcome was HbA1c ( % ) at six-months . Results We r and omised 59 participants to each group and obtained six-month HbA1c outcomes from 53 and 51 participants in the intensive and conventional education groups , respectively . Intensive group participants had a mean six-month HbA1c ( % ) of 8.4 ( 95 % CI : 8 to 8.9 ) , while participants in the conventional education group had a mean six-month HbA1c ( % ) of 10.2 ( 95 % CI : 9.8 to 10.7 ) . The difference was statistically ( P < 0.0001 ) and clinical ly significant , with intensive group participants having HbA1c outcomes on average -1.8 ( 95 % CI : -2.4 to -1.2 ) percentage points lower than conventional group participants . Results were robust to adjustment for a range of covariates and multiple imputation of missing outcome data . Conclusions This study demonstrates the effectiveness of a structured , guideline -based DSME intervention in a LMIC setting versus a pragmatic comparator . The intervention is potentially replicable at other levels of the Nigerian healthcare system and in other LMICs , where nurses/diabetes educators can run the programme . Trial Registration Pan African Clinical Trial Registry
Conclusion Based on available literature , evidence suggests that community-based interventions may reduce the incidence rate of T2DM and may positively affect anthropometric indices and HbA1C .
Due to the heterogeneity observed between trials we recommend more well- design ed RCTs with longer follow-up duration s be executed , to confirm whether community-based interventions lead to reduced T2DM events in the at-risk population of LMIC setting
Background The increasing prevalence of type 2 diabetes mellitus ( T2DM ) can have a substantial impact in low- and middle-income countries ( LMICs ) .
Community-based programs addressing diet , physical activity , and health behaviors have shown significant benefits on the prevention and management of T2DM , mainly in high-income countries .
However , their effects on preventing T2DM in the at-risk population of LMICs have not been thoroughly evaluated .