Research ers noted small improvements in body mass index immediately after the intervention was provided and at six months , along with improved weight post intervention .
Diabetes knowledge and self efficacy improved immediately following receipt of the intervention , and knowledge also at six months .
The intervention did not improve blood pressure .
Evidence is insufficient to show whether type 2 diabetes self management interventions for people with severe mental illness are effective in improving outcomes .
BACKGROUND People with severe mental illness are twice as likely to develop type 2 diabetes as those without severe mental illness .
Treatment guidelines for type 2 diabetes recommend that structured education should be integrated into routine care and should be offered to all .
However , for people with severe mental illness , physical health may be a low priority , and motivation to change may be limited .
These additional challenges mean that the findings reported in previous systematic review s of diabetes self management interventions may not be generalised to those with severe mental illness , and that tailored approaches to effective diabetes education may be required for this population .
OBJECTIVES To assess the effects of diabetes self management interventions specifically tailored for people with type 2 diabetes and severe mental illness .
Cost-effectiveness of a stepped-care intervention to prevent major depression in patients with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression: design of a cluster-randomized controlled trial
Background Co-morbid major depression is a significant problem among patients with type 2 diabetes mellitus and /or coronary heart disease and this negatively impacts quality of life . Subthreshold depression is the most important risk factor for the development of major depression . Given the highly significant association between depression and adverse health outcomes and the limited capacity for depression treatment in primary care , there is an urgent need for interventions that successfully prevent the transition from subthreshold depression into a major depressive disorder . Nurse led stepped-care is a promising way to accomplish this . The aim of this study is to evaluate the cost-effectiveness of a nurse-led indicated stepped-care program to prevent major depression among patients with type 2 diabetes mellitus and /or coronary heart disease in primary care who also have subthreshold depressive symptoms . Methods / design An economic evaluation will be conducted alongside a cluster-r and omized controlled trial in approximately thirty general practice s in the Netherl and s. R and omization takes place at the level of participating practice nurses . We aim to include 236 participants who will either receive a nurse-led indicated stepped-care program for depressive symptoms or care as usual .  The stepped-care program consists of four sequential but flexible treatment steps : 1 ) watchful waiting , 2 ) guided self-help treatment , 3 ) problem solving treatment and 4 ) referral to the general practitioner . The primary clinical outcome measure is the cumulative incidence of major depressive disorder as measured with the Mini International Neuropsychiatric Interview . Secondary outcomes include severity of depressive symptoms , quality of life , anxiety and physical outcomes . Costs will be measured from a societal perspective and include health care utilization , medication and lost productivity costs . Measurements will be performed at baseline and 3 , 6 , 9 and 12 months . Discussion The intervention being investigated is expected to prevent new cases of depression among people with type 2 diabetes mellitus and /or coronary heart disease and subthreshold depression , with subsequent beneficial effects on quality of life , clinical outcomes and health care costs . When proven cost-effective , the program provides a viable treatment option in the Dutch primary care system . Trial registration Dutch Trial Register
Research ers noted small improvements in body mass index immediately after the intervention was provided and at six months , along with improved weight post intervention .
Diabetes knowledge and self efficacy improved immediately following receipt of the intervention , and knowledge also at six months .
The intervention did not improve blood pressure .
Evidence is insufficient to show whether type 2 diabetes self management interventions for people with severe mental illness are effective in improving outcomes .
BACKGROUND People with severe mental illness are twice as likely to develop type 2 diabetes as those without severe mental illness .
Treatment guidelines for type 2 diabetes recommend that structured education should be integrated into routine care and should be offered to all .
However , for people with severe mental illness , physical health may be a low priority , and motivation to change may be limited .
These additional challenges mean that the findings reported in previous systematic review s of diabetes self management interventions may not be generalised to those with severe mental illness , and that tailored approaches to effective diabetes education may be required for this population .
OBJECTIVES To assess the effects of diabetes self management interventions specifically tailored for people with type 2 diabetes and severe mental illness .