The effect of an education programme (MEDIAS 2 ICT) involving intensive insulin treatment for people with type 2 diabetes

Hermanns, Norbert; Kulzer, Bernhard; Maier, Berthold; Mahr, Marina; Haak, Thomas

doi:10.1016/j.pec.2011.05.017

Cited by 38 publications

(117 citation statements)

References 21 publications

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“…Therefore, we cannot conclude that the increased distress associated with insulin treatment was due to the prescription of insulin per se . In fact, others have shown that, when accompanied by structured, group-based education and support, intensive treatment with insulin in type 2 diabetes can actually reduce diabetes distress [60]. …”

Section: Discussionmentioning

confidence: 99%

Diabetes Burden and Diabetes Distress: the Buffering Effect of Social Support

2014

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Background Few studies have examined protective factors for diabetes distress. Purpose To examine the moderating role of social support in the relationship between the burden of diabetes and diabetes distress. Methods Adults with type 2 diabetes (N=119; 29% Latino, 61% Black, 25% White) completed validated measures of diabetes distress and social support. Multiple linear regression evaluated the moderating role of social support in the relationship between diabetes burden, indicated by prescription of insulin and presence of complications, and distress. Results Greater support satisfaction was significantly associated with lower distress after controlling for burden. Support satisfaction and number of supports significantly moderated the relationship between diabetes burden and distress. Post-hoc probing revealed a consistent pattern: Insulin was significantly associated with more diabetes distress at low levels of support but was not at high levels of support. Conclusion Findings support the stress-buffering hypothesis and suggest that social support may protect against diabetes distress.

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Section: Discussionmentioning

confidence: 99%

Diabetes Burden and Diabetes Distress: the Buffering Effect of Social Support

2014

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“…The CG received diabetes education, which has been shown to produce a beneficial impact on diabetesrelated distress (39,40). Furthermore, the study included high proportions of patients with type 1 or type 2 diabetes, who were treated primarily with insulin and had diabetes for a rather long time.…”

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confidence: 99%

The Effect of a Diabetes-Specific Cognitive Behavioral Treatment Program (DIAMOS) for Patients With Diabetes and Subclinical Depression: Results of a Randomized Controlled Trial

et al. 2015

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OBJECTIVESubclinical depression is one of the most frequent mental comorbidities in patients with diabetes and is associated with a poorer long-term prognosis. Since there is a lack of specific intervention concepts for this patient group, a selfmanagement-oriented group program (DIAMOS [Diabetes Motivation Strengthening]) was newly developed and evaluated in a randomized trial. RESEARCH DESIGN AND METHODSDIAMOS is composed of cognitive behavioral interventions aiming at the reduction of diabetes distress. The active control group (CG) received diabetes education. The primary outcome was depressive symptoms. Secondary outcomes were diabetes distress, well-being, self-care behavior, diabetes acceptance, diabetes treatment satisfaction, HbA 1c , and subclinical inflammation. RESULTSTwo hundred fourteen participants (mean age 43.3 6 13.3 years, female sex 56.5%, type 2 diabetes 34.1%, mean diabetes duration 14.2 6 10.5 years, HbA 1c 8.9 6 1.8%, BMI 28.7 6 71 kg/m 2 ) were randomized. The 12-month follow-up revealed a significantly stronger reduction of depressive symptoms (Center for Epidemiologic Studies Depression Scale score) in the DIAMOS group compared with the CG (D3.9 [95% CI 0.6-7.3], P = 0.021). Of the secondary variables, the Patient Health Questionnaire-9 (D1.7 [95% CI 0.2-3.2], P = 0.023), Problem Areas in Diabetes scale (D8.2 [95% CI 3.1-13.3], P = 0.002), and Diabetes Distress Scale scores (D0.3 [95% CI 0.1-0.5], P = 0.012) displayed significant treatment effects. Moreover, the risk of incident major depression in the DIAMOS group was significantly reduced (odds ratio 0.63 [95% CI 0.42-0.96], P = 0.028). Inflammatory variables were not substantially affected. CONCLUSIONSDIAMOS is more effective in lowering depressive symptoms and diabetes-related distress in diabetic patients with subclinical depression. DIAMOS also has a preventive effect with respect to the incidence of major depression.

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“…Participants in MEDIAS 2 ICT achieved a significant improvement of the health-related bodily quality of life, of the self-treatment behaviour, and a reduction of diabetesrelated impairments (all p < 0.05). The reduction of diabetesrelated impairments was significantly greater in the MEDIAS 2 ICT group compared with the control group (p = 0.031) ( [130] level of evidence Ib).…”

Section: Treatment and Education Programmes For Intensified Insulin Tmentioning

confidence: 92%