Blood glucose testing and primary prevention of diabetes mellitus type 2 - evaluation of the effect of evidence based patient information

Abstract

BackgroundEvidence-based patient information (EBPI) has been recognised as important tool for informed choice in particular in the matter of preventive options. An objective, on the best scientific evidence-based consumer information about subthreshold elevated blood glucose levels (impaired fasting glucose and impaired glucose tolerance) and primary prevention of diabetes, is not available yet. Thus we developed a web-based EBPI and aim to evaluate its effects on informed decision making in people 50 years or older.Methods/DesignWe conduct a web-based randomised-controlled trial to evaluate the effect of information about elevated blood glucose levels and diabetes primary prevention on five specific outcomes: (i) knowledge of elevated blood glucose level-related issues (primary outcome); (ii) attitudes to a metabolic testing; (iii) intention to undergo a metabolic testing; (iv) decision conflict; (v) satisfaction with the information. The intervention group receives a specially developed EBPI about subthreshold elevated blood glucose levels and diabetes primary prevention, the control group information about this topic, available in the internet.The study population consists of people between 50 and 69 years of age without known diabetes. Participants will be recruited via the internet page of the cooperating health insurance company, Techniker Krankenkasse (TK), and the internet page of the German Diabetes Centre. Outcomes will be measured through online questionnaires. We expect better informed participants in the intervention group.DiscussionThe design of this study may be a prototype for other web-based prevention information and their evaluation.Trial registrationCurrent Controlled Trial: ISRCTN22060616.

History of socioeconomic disadvantage and allostatic load in later life

“…Thus, biological functioning in middle and later adulthood may be particularly affected by recent SES adversity experience, but still bear the scars of SES adversity experience earlier in the life course. A number of investigations have found that associations between childhood SES and health indicators in adulthood are attenuated when accounting for adult SES, although, similar to the present findings, some investigations still find an independent association for childhood SES (e.g., Galobardes et al, 2008; Haas, 2008; Tamayo et al, 2010). …”

“…This includes risk of development of infectious illness, as well as chronic health conditions, such as heart disease, diabetes, and poor cognitive and physical functioning (see Cohen, 1999; Kaplan & Keil, 1993; Strike & Steptoe, 2004; Tamayo et al, 2010). Those of lower SES are also at greater risk of disease-specific and all-cause mortality (e.g., Lynch et al, 1994; Turrell et al, 2007).…”

Socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions?

“…Further variables included were knowledge before intervention (ordinal, 4 questions = 0 to 4 correct answers = 4 values), self-reported former blood glucose measurements (surveyed: yes/no), increased blood pressure (high: yes/no) and blood lipid levels (elevated: yes/no), age and gender as potential confounders [7, 10]. Demographic and socioeconomic variables of the study population were described by frequency tables and mean ± standard deviation depending on the distribution of the variables, stratified by the intervention and control groups.…”

Blood glucose testing and primary prevention of Type 2 diabetes—evaluation of the effect of evidence‐based patient information: a randomized controlled trial

“…Further details can be found in the published study protocol [15] and in the Supporting Information (Appendix S1). Individuals were randomly assigned to the intervention group receiving evidence-based patient information, and the control group receiving standard information from the Internet.…”