Limited evidence exists on the efficacy of Diabetes Self-Management Education (DSME) in primary care urban population in low- and middle-income countries. This study evaluated the effect on glycemic control and insulin dosing in patients who attended an interdisciplinary educative structured program at Clínica Especializada en el Manejo de la Diabetes in México City-Iztapalapa in 2017. Intervention lasted 5 months and included individual and group sessions in a shared medical appointments model aimed at promoting self-care. In 252 patients with type 2 diabetes, diabetes literacy and self-care activities were assessed from the 10-item Spoken Knowledge in Low Literacy in Diabetes (SKILL-D, score 0-100) and the Summary of Diabetes Self-Care Activities (SDSCA, days/week), respectively. Women represented 67% and 59.6% had elementary or less education. Mean age was 55±10 years old, mean duration of diabetes was 13±8 years and 66% were on insulin treatment. SKILL-D and SDSCA scores increased from 22±19 to 80±16 and 2.5±1.4 to 4.7±1 days/week, respectively. HbA1c decreased from 9.3±2.1 to 6.7±1.1% (mean variation 2.5±2.1%; p<0.001) and daily total insulin dose decreased from 37±17 to 23±13 units (mean variation 13.5±14.7 units; p<0.001). Only in 22% another drug agent was added, in 18% insulin was discontinued and in 3% insulin started. Diabetes literacy and self-care activities were poor at the beginning of the study. This is a real-world study that showed that a non-pharmacological approach focused on promoting self-care, such as DSME, had in important effect on HbA1c reduction and insulin dosing in urban areas patients with low literacy, but also suggested an insulin over-prescription practice with lack of adherence/prescription to/of lifestyle interventions, before participation in this program. Disclosure R. Silva-Tinoco: Speaker's Bureau; Self; Novartis Pharmaceuticals Corporation. D.G. Meza: None. D. Garcia Martinez: None. J. Orozco: None. M. Romero-Ibarguengoitia: None. V.A. De La Torre-Saldañ: None. J.A. Ramos Garcia: None. M.C. Dolores: None. E. Cuatecontzi: None.
Quality of life(QoL) is an important health outcome and diabetes affects major components of QoL, including physical, psychological and social. There is limited evidence about the effect of Diabetes Self-Management Education (DSME) on QoL in primary care urban population of low- and middle-income countries. This study evaluated the effect on Health-Related Quality of Life (HRQoL) in patients who attended an interdisciplinary educative structured program at Clínica Especializada en el Manejo de la diabetes in México City-Iztapalapa in 2017. Intervention lasted 5 months and included individual and group sessions in a shared medical appointments model aimed at promoting self-care. In 252 patients with type 2 diabetes, HRQoL was assessed from the EuroQoL 5D-5L, which is a generic instrument for this purpose including 5 dimensions: mobility, self-care, daily activities, pain/discomfort, and anxiety/depression. It reports an indexed score and a visual analogue scale (VAS) score, and highest scores obtainable are of 1 and 100, respectively. Women represented 67%, and 59.6% had elementary or less education. Mean age was 55±10 years old, and mean duration of diabetes was 13±8 years. Indexed score and VAS score increased from 0.76±0.14 to 0.87±0.14 (mean variation 0.1±0.14; p=<0.001) and from 62.6±24 to 88.4±11 (mean variation 25.7±26; p=<0.001), respectively. The highest improvement in a HRQoL dimension was the decreased proportion of patients without problems perception related to anxiety/depression from 63.2% to 26% (p=<0.001). This non-pharmacological therapeutic approach focused on DSME improved HRQoL. Our findings suggest the role of DSME in this population beyond the traditional physical component impact, since it favors the fulfillment of multiple interrelated objectives through different mechanisms, generating a diversity of positive results, including HRQoL. Disclosure R. Silva-Tinoco: Speaker's Bureau; Self; Novartis Pharmaceuticals Corporation. E. Cuatecontzi: None. A. Gómez Alonso: None. M. Romero-Ibarguengoitia: None. V.A. De La Torre-Saldañ: None. M.D. Cabrera-Gerardo: None. E.B. Guzmán Olvera: None. E. González: None. D.G. Meza: None.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.