Effectiveness of an intervention to improve diabetes self-management on clinical outcomes in patients with low educational level

Lima, Antonio Olry de Labry; Tamayo, Clara Bermúdez; Pastor‐Moreno, Guadalupe; Muñoz, Juan Jesús López-Guadalupe; Ruiz-Pérez, Isabel; Johri, Mira; Vela, Pilar Cruz; Álvarez, Ana M. de los Ríos; Quel, Miguel Ángel Prados; López, Enrique Moratalla; Martín, Susana Domínguez; Hierro, José Andrés Lopez de; Ricci‐Cabello, Ignacio

doi:10.1016/j.gaceta.2016.05.017

Cited by 16 publications

(14 citation statements)

References 25 publications

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“…These results are consistent with previous similar studies conducted among diabetic patients in other countries [15][16][17][18][19] and suggest that nutrition education can be effective in helping these patients with their condition. Several studies have explored the efficiency of different interventions aiming at improving the management of diabetes, especially in vulnerable populations 20,21 and despite the difference in the approaches, they observed a decreasing Hb1Ac.…”

Section: Discussionsupporting

confidence: 93%

Comparison of two approaches to nutrition education in the management of diabetic patients

Zeghari¹,

Aboussaleh²,

Ateilah³

et al. 2018

AOWMC

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Introduction: Nutrition education is one of the fundamental axes in the management of diabetes. Objective: study the impact of two types of nutrition education (personalized and collective) on the glycemic control of diabetics in the province of Kenitra. Material and methods: The population was composed of 184 patients (86 men, 98 women) with an average age of (51.7±14.0) and an age range of [20 to 88.5]. Data collection was carried out using a questionnaire containing socio-demographic and anthropometric information. Glycemic control was based on fasting glucose (GAJ), postprandial glucose (GPP), and glycated hemoglobin (HbA1c). These analyzes were taken in three separate phases with a duration of 3 months; T0 represents the initial state (before our intervention), t 1 and t 2 which represent the values of the three analyzes after our intervention. Participants were randomized into two groups: a group that received collective nutrition education (n=105) and another group (n=79) had a personalized (individual) education. BMI was the only anthropometric measure used. Results: The whole population is overweight (BMI>25) for either women or men, also the results of glycemic control are superior to the norms in the three stages (t 0 , t 1 or t 2). Nutrition education Personalized shows statistically significant differences in the variables studied as a function of time more than those studied in collective nutrition education (p=0.00 <0.05). Also the difference is significant between collective nutrition education and personalized nutritional education (P=0.00 <0.05) for the means of HBA1C (%) at t 1 and at t 2 ; Fasting glucose (g / l) at t 1 and t 2 and post-prandial glucose (g / l) at t 1 and t 2. Conclusion: The results of this study show that collective nutrition education yields significant results in terms of impact on glycemic control of theses diabetics. The number of studies on this aspect (nutrition education) remains modest, another study is desirable on a larger sample to better confirm our results.

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Section: Discussionsupporting

confidence: 93%

Comparison of two approaches to nutrition education in the management of diabetic patients

Zeghari¹,

Aboussaleh²,

Ateilah³

et al. 2018

AOWMC

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“…pain intensity, level of fatigue and use of pain medication). Seventeen studies targeting diabetes reported mean changes in HbA1c, with seven reporting significant improvements in the intervention compared to usual care [42, 46, 47, 50, 52, 53, 56, 109, 112]. Goudswaard et al [42] reported a decrease in HbA1c at six weeks by 0.7% more (95% CI 0.1, 1.4) in those receiving the intervention when compared with control.…”

Section: Resultsmentioning

confidence: 99%

Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice

et al. 2019

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Background Primary health professionals are well positioned to support the delivery of patient self-management in an evidence-based, structured capacity. A need exists to better understand the active components required for effective self-management support, how these might be delivered within primary care, and the training and system changes that would subsequently be needed. Objectives (1) To examine self-management support interventions in primary care on health outcomes for a wide range of diseases compared to usual standard of care; and (2) To identify the effective strategies that facilitate positive clinical and humanistic outcomes in this setting. Method A systematic review of randomized controlled trials evaluating self-management support interventions was conducted following the Cochrane handbook & PRISMA guidelines. Published literature was systematically searched from inception to June 2019 in PubMed, Scopus and Web of Science. Eligible studies assessed the effectiveness of individualized interventions with follow-up, delivered face-to-face to adult patients with any condition in primary care, compared with usual standard of care. Matrices were developed that mapped the evidence and components for each intervention. The methodological quality of included studies were appraised. Results 6,510 records were retrieved. 58 studies were included in the final qualitative synthesis. Findings reveal a structured patient-provider exchange is required in primary care (including a one-on-one patient-provider consultation, ongoing follow up and provision of self-help materials). Interventions should be tailored to patient needs and may include combinations of strategies to improve a patient’s disease or treatment knowledge; independent monitoring of symptoms, encouraging self-treatment through a personalized action plan in response worsening symptoms or exacerbations, psychological coping and stress management strategies, and enhancing responsibility in medication adherence and lifestyle choices. Follow-up may include tailored feedback, monitoring of progress with respect to patient set healthcare goals, or honing problem-solving and decision-making skills. Theoretical models provided a strong base for effective SMS interventions. Positive outcomes for effective SMS included improvements in clinical indicators, health-related quality of life, self-efficacy (confidence to self-manage), disease knowledge or control. An SMS model has been developed which sets the foundation for the design and evaluation of practical strategies for the construct of self-management support interventions in primary healthcare practice. Conclusions These findings provide primary care professionals with evidence-based strategies and structure to deliver SMS in practice. For this collaborative partnership approach to be more widely applied, future research should build on these findings for optimal SMS servic...

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“…The characteristics of the studies included in this review are summarised in online supplemental table 1. The studies were conducted in the USA (n=13, 76.5%), [31][32][33][34][35][36][37][38][39][40][41][42][43] the UK (n=2), 44 45 Spain (n=1) 46 and the Netherlands (n=1). 47 Eight studies were conducted among migrants of European, Caucasian, American, Mexican or Middle East background, 31-35 40 41 46 five among those of black and African backgrounds 36-39 42 and four 43-45 47 among South Asian migrants.…”

Section: Participants Characteristics and Study Designsmentioning

confidence: 99%

Lifestyle interventions for type 2 diabetes management among migrants and ethnic minorities living in industrialized countries: a systematic review and meta-analyses

Rawal

Sahle

Smith

et al. 2021

BMJ Open Diab Res Care

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The objective of this systematic review was to determine the effectiveness of lifestyle interventions to improve the management of type 2 diabetes mellitus (T2DM) among migrants and ethnic minorities. Major searched databases included MEDLINE (via PubMed), EMBASE (via Ovid) and CINAHL. The selection of studies and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In the meta-analysis, significant heterogeneity was detected among the studies (I2 >50%), and hence a random effects model was used. Subgroup analyses were performed to compare the effect of lifestyle interventions according to intervention approaches (peer-led vs community health workers (CHWs)-led). A total of 17 studies were included in this review which used interventions delivered by CHWs or peer supporters or combination of both. The majority of the studies assessed effectiveness of key primary (hemoglobin (HbA1c), lipids, fasting plasma glucose) and secondary outcomes (weight, body mass index, blood pressure, physical activity, alcohol consumption, tobacco smoking, food habits and healthcare utilization). Meta-analyses showed lifestyle interventions were associated with a small but statistically significant reduction in HbA1c level (−0.18%; 95% CI −0.32% to −0.04%, p=0.031). In subgroup analyses, the peer-led interventions showed relatively better HbA1c improvement than CHW-led interventions, but the difference was not statistically significant (p=0.379). Seven studies presented intervention costs, which ranged from US$131 to US$461 per participant per year. We conclude that lifestyle interventions using either CHWs or peer supporters or a combination of both have shown modest effectiveness for T2DM management among migrants of different background and origin and ethnic minorities. The evidence base is promising in terms of developing culturally appropriate, clinically sound and cost-effective intervention approaches to respond to the growing and diverse migrants and ethnic minorities affected by diabetes worldwide.

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Effectiveness of an intervention to improve diabetes self-management on clinical outcomes in patients with low educational level

Cited by 16 publications

References 25 publications

Comparison of two approaches to nutrition education in the management of diabetic patients

Comparison of two approaches to nutrition education in the management of diabetic patients

Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice

Lifestyle interventions for type 2 diabetes management among migrants and ethnic minorities living in industrialized countries: a systematic review and meta-analyses

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