Effect of a Nurse-Led Diabetes Self-Management Education Program on Glycosylated Hemoglobin among Adults with Type 2 Diabetes

Abstract

In recent years, great emphasis has been placed on the role of nonpharmacological self-management in the care of patients with diabetes. Studies have reported that nurses, compared to other healthcare professionals, are more likely to promote preventive healthcare seeking behaviors. The aim of this study was to investigate the effectiveness of a nurse-led diabetes self-management education on glycosylated hemoglobin. A two-arm parallel-group randomized controlled trial with the blinded outcome assessors was designed. One hundred forty-two adults with type 2 diabetes were randomized to receive either usual diabetes care (control group) or usual care plus a nurse-led diabetes self-management education (intervention group). Duration of the intervention was 12 weeks. The primary outcome was glycosylated hemoglobin (HbA1c values). Secondary outcomes were changes in blood pressure, body weight, lipid profiles, self-efficacy (efficacy expectation and outcome expectation), self-management behaviors, quality of life, social support, and depression. Outcome measures were assessed at baseline and at 12-week and 24-week postrandomizations. Patients in the intervention group showed significant improvement in HbA1c, blood pressure, body weight, efficacy expectation, outcome expectation, and diabetes self-management behaviors. The beneficial effect of a nurse-led intervention continued to accrue beyond the end of the trial resulting in sustained improvements in clinical, lifestyle, and psychosocial outcomes. This trial is registered with IRCT2016062528627N1.

Lifestyle factors, self-management and patient empowerment in diabetes care

“…weight, blood pressure, lipids, glycaemic control) and reduction in the risk of CV events. [85][86][87][88] Studies assessing the impact of DSME programmes vary in a number of parameters such as methods (e.g. patient empowerment, 38 intensive interventions, 62,77 digital health technology, 40 providers of DSME, duration, intensity and content of education, follow-up intervals and participant characteristics.…”

The Effects of Nurse-Led Multidisciplinary Team Management on Glycosylated Hemoglobin, Quality of Life, Hospitalization, and Help-Seeking Behavior of People with Diabetes Mellitus

“…Sadly, according to some studies, the leadership role of nurses has been overemphasized, leading to neglect of the importance of multidisciplinary teams. Quite a few teams were only made up of nurses and community health workers, sometimes including primary care physicians or pharmacists rather than multidisciplinary teams [15,16,19]. Even for multidisciplinary team management, the central role was usually played by primary care physicians or specialists instead of nurses [20][21][22].…”

“…Even for multidisciplinary team management, the central role was usually played by primary care physicians or specialists instead of nurses [20][21][22]. Furthermore, the duration of follow-up was usually less than one year, long-term effects of nurse-led multidisciplinary team were scarce [19,23]. Although patients were uniquely qualified to say whether the intervention was acceptable or suitable for them [24,25], most studies only focused on the effects of clinical outcomes or self-care.…”

Effectiveness of non-pharmacological strategies in the management of type 2 diabetes in primary care: a protocol for a systematic review and network meta-analysis

“…Based on our previous search in the literature, the interventions may be (1) nutritional therapy (dietary quality or energy restriction),20 (2) physical activity programme (running, walking, bicycling, swimming, resistance training, yoga, Tai chi),20 (3) psychological interventions (emotion-focused or cognition-focused),11 (4) social network interventions (friends, families and peers),12 (5) multidisciplinary lifestyle interventions (an intervention that combines at least two of the following modalities: physical activity, nutritional therapy, social or psychological support),21 (6) diabetes self-management education and support (DSMES),22 (7) technology-enabled DSMES (mobile phones, secure messaging, web-based information),23(8) interventions delivered only or mainly by pharmacists (DSMES and/or pharmacy management),24 (9) interventions delivered only or mainly by nurses (DSMES and/or pharmacy management),25 (10) self-blood glucose monitoring in non-insulin-treated T2DM,26 (11) health coaching27 and (12) benchmarking 28…”