Self-management education may improve blood pressure in people with type 2 diabetes. A randomized controlled clinical trial

Abstract

Background and aims: Diabetes is a suitable model to evaluate intervention programmes aimed at chronic diseases, because of its well-defined and measurable process and outcome indicators. In this study, we aimed at investigating the effects of group based selfmanagement education on clinical and psychological variables in type 2 diabetes. Methods and results: Four-year randomized controlled clinical trial (ISRCTN14558376) comparing Group Care and traditional one-to-one care. Clinical and psychological variables were monitored at baseline, 2 and 4 years. Although differences between groups appear to be non-significant at univariate analysis, body weight, BMI and HbA1c, systolic and diastolic blood pressure improved in the patients followed by Group Care but not among Controls. Prescription of lipid-lowering and anti-hypertensive agents did not change among the patients on Group Care, whereas antihypertensives were stepped up among Controls without improving their blood pressure. Multivariable analysis suggests that blood pressure improvement among patients on Group Care was independent of BMI, duration of diabetes and antihypertensive medication, suggesting a direct effect of education, presumably by increasing adherence. The "Powerful Others" dimension of the Locus of Control worsened and fear of complications decreased among Controls. Conclusions: The results confirm that a multidisciplinary structured group educational approach improves blood pressure, presumably through better adherence to healthy lifestyle and medication, in people with type 2 diabetes. Clinical trial registration number: ISRCTN14558376.

Lipohypertrophy in Elderly Insulin-Treated Patients With Type 2 Diabetes

“…However, we also feel a large responsibility to fight therapeutic inertia given the evidence for severeand even potentially life-threatening-HEs due to an avoidable high rate of LHs. We feel that a new structured education approach that is specifically designed for the elderly should be implemented on an experimental basis, possibly based on models showing effectiveness for other purposes, like the so-called ''group care'' model [28,29]. It is notable that even showing patients their lesions during US scanning procedures has proven to be quite convincing and educationally compelling per se [8].…”

Patient empowerment and self‐management behaviour of chronic disease patients: A moderated mediation model of self‐efficacy and health locus of control

“…It can help patients develop skills to manage diseases more effectively and is now considered an essential part of chronic condition management (Taylor et al, 2014). A great deal of studies shows the impact of self‐management on chronic disease outcomes, including improvement of treatment adherence (Poowuttikul & Seth, 2020), symptom control (Trento et al, 2020), quality of life (Lenferink et al, 2017), and healthy behaviour factors (Dye et al, 2018).…”

Potential Biomarkers for Predicting Depression in Diabetes Mellitus

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