Results of a pilot study of patient-to-patient education strategy on self-management among glycemic uncontrolled patients with diabetes

Abstract

ObjectivesThe purpose of this study was to assess the efficacy and practicability of patient-to-patient (PTP) education strategy on glycemic control among patients with type 2 diabetes mellitus.MethodsEligible subjects from outpatient clinic were recruited and randomized to either intervention group or control group. Inpatients with poor outcomes and complications acted as mentors to share their experience with the intervention group in three tailored classes. Besides, the intervention group received general advice from specialists. The control group received general advice only. The glucose metabolic status and behavior modification indicators were evaluated before and after intervention. In addition, both groups finished a questionnaire survey regarding awareness to diabetic complications after intervention.ResultsEighty-four subjects were recruited (42 subjects for each group), and 51 subjects finished the study. Both the intervention group (n=29) and the control group (n=22) showed a tendency toward a decrease in glycosylated hemoglobin level (A1c, −0.8% vs −0.4%, P<0.05) and improvement in behavior modification (+5.0 vs +2.8, P<0.05) after 6 months. The intervention group (13.8%) obtained a higher percentage than the control group (9.1%) whose A1c reached ≤7%. The body mass index did not change significantly in any group. The questionnaire score about complication awareness was higher in the intervention group than in the control group.ConclusionThis preliminary evidence suggests that PTP education strategy is acceptable for facilitating the outcome of glycemic control. Patient sense of complications may work on A1c reduction.

The effectiveness of peer-supported interventions for encouraging dietary behaviour change in adults: a systematic review

“…A total of forty studies assessed the effect of PSI on anthropometric outcomes. Anthropometric data were objectively measured in these studies; however, methods (28) Dietary pattern ✓ Robinson-Whelen et al (2006) (32) Dietary pattern ✓ Resnicow et al (2004) (58) FV ✓ Campbell et al (1999) (55) FV ✓ Toobert et al (2007) (35) Fat ✓ West et al (2011) (26) Weight ✓ Ackermann et al (2015) (29) Weight ✓ Lutes et al (2017) (48) Weight ✓ Safford et al (2015) (52) BMI ✓ Katula et al (2013) (61) Multiple weight (weight, BMI, WC) ✓ Block et al (2015) (41) Multiple weight (weight, BMI, WC) ✓ Yang et al (2016) (33) Multiple weight (weight, BMI, WC) ✓ Jebb et al (2011) (31) Multiple weight (weight, WC) ✓ Debussche et al (2018) (24) Multiple weight (BMI, WC) ✓ Heshka et al (2003) (16) Multiple weight (weight, BMI, WC/WHR) ✓ Corkery et al (1997) (44) Dietary pattern ✓ Gary et al (2003) (49) Dietary pattern ✓ Stoddard et al (2004) (56) FV ✓ Allicock et al (2012) (67) FV ✓ Van der Wulp et al (2012) (51) Fat ✓ Glasgow et al (2003) (38) Multiple dietary (fat, other nutrients/foods) ✓ Prezio et al (2013) (47) BMI ✓ Peimani et al (2018) (57) BMI ✓ Islam et al (2013) (60) Multiple weight (weight, BMI, WC) ✓ Pérez-Escamilla et al (2015) (46) Multiple weight (weight, BMI, WC) ✓ Verheijden et al (2004) (39) Multiple weight (BMI, WC/WHR) ✓ Sreedevi et al (2017) (53) Multiple weight (BMI, WHR) ✓ Carrasquillo et al (2017) (65) Diet and weight (FV, BMI) ✓ Cade et al (2009) (19) Diet and weight (FV, fat, other nutrients/foods, weight, BMI) ✓ Spencer et al (2011) (64) Diet and weight (FV, fat, other nutrients/foods, BMI) ✓ Mash et al (2014) (23) Diet and weight (dietary pattern, weight, WC) ✓ Xiang et al (2017) (18) Diet and weight (dietary pattern, BMI) ✓ ...…”

“…Group support was largely delivered face-to-face (n 22; 73 %) or was delivered via teleconference (n 1; 3 %) or was web-based (n 7; 23 %). Dyadic support was delivered face-to-face (n 4; 40 %), via (59) Diet and weight (fat, other nutrients/foods, weight, BMI, WC/WHR) ✓ Parikh et al (2010) (21) Diet and weight (FV, fat, other nutrients/foods, weight, WC) ✓ Rosal et al (2011) (54) Diet and weight (dietary pattern, fat, other nutrients/foods, weight, WC) ✓ Smith et al (2011) (22) Diet and weight (dietary pattern, BMI) ✓ Pinto et al (2013) (17) Diet and weight (other nutrients/ foods, weight) ✓ Rothschild et al (2014) (45) Diet and weight (FV, weight) ✓ Baig et al (2015) (27) Diet and weight (dietary pattern, FV, fat, WC) ✓ Hageman et al (2017) (36) Diet and weight (fat, other nutrients/foods, weight, WC) ✓ Jane et al (2017) (42) Diet (27) One item from Summary of Diabetes Self-Care Activity Scale (18) Diabetes self-care self-report q'naire including four items on diet (v) (45) One item from Summary of Diabetes Self-Care Activity Scale 1. Self-management intervention 2.…”

Influence of Health Education on Podiatric Knowledge, Self-care, and Conditions in Adults With Diabetes Mellitus: A Systematic Review

“…Despite the importance of this subject, the scientific evidence available on the effectiveness of education is limited, 9 and no cost-benefit evaluation over the long term has been established. Accordingly, this systematic review aimed to determine how health education may have an influence on podiatric knowledge, self-care, and foot conditions in adults with DM.…”

Teoría específica sobre las conductas familiares de las personas con diabetes tipo 2

“…Existe evidencia de que el padecimiento es resultado de los cambios culturales y sociales que se están viviendo en la actualidad, como el envejecimiento de la población, incremento de la urbanización, nuevas dietas alimenticias, disminución de la actividad física y empleos más sedentarios (6) . Se considera que dicho padecimiento requiere de una atención, educación, apoyo continuo para prevenir el desarrollo de la enfermedad y el retraso las complicaciones y sobre todo la mortalidad prematura de las personas afectadas (7) .…”

“…La autogestión es la clave para lograr un control del padecimiento, lo que contribuiría de manera significativa al retraso de las complicaciones y mejoramiento de la calidad de vida de las personas a corto y largo plazo (7,13) . Ésta es entendida como aquellas acciones o actividades realizadas por la persona, encaminadas al monitoreo de signos y síntomas (manejo de hipoglucemias e hiperglucemias, y el cuidado de los pies) el mantenimiento y la mejora de los comportamientos de la salud (mejorar sus patrones de alimentación, actividad física, medicación, abandono del consumo de alcohol y tabaco) y la disminución del impacto negativo de la enfermedad (manejo del estrés, de complicaciones y efectos secundarios) (7,14) .…”