Abstract TP190: The Effectiveness of a Person-centered Empowerment-based Self-management Intervention in Reducing Risk of Stroke Among Male Patients With Poorly Controlled Type 2 Diabetes: A Mixed-method Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Li Cheng ◽  
Janet W Sit ◽  
Sek-ying Chair
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Mixed Method ◽  
Intervention Group ◽  
Self Management ◽  
Post Intervention ◽  
Management Intervention ◽  
Male Patients ◽  
Male Subjects

Introduction: The overall incidence of stroke was higher in men than women. Type 2 diabetes is found to be a risk factor for stroke. Previous prospective studies showed each 1% increase in HbA1c would be associated with 12% increase in the risk of developing a stroke. Identifying effective strategies to optimize the glycemic control of male patients with poorly controlled type 2 diabetes would be valuable for reducing the risk of stroke. This mixed-method study aims to examine how male patients with poorly controlled type 2 diabetes responded to a person-centered empowerment-based self-management intervention. Methods: Phase I study was based on a sub-group analysis of 179 male subjects with poorly controlled type 2 diabetes [with Glycated hemoglobin (HbA1c) ≥7.5%] who received a six-week empowerment-based self-management intervention (n= 93) or attentional control (n= 86), respectively. The primary outcome was HbA1c level from baseline to three-month post-intervention. Phase II study was an in-depth individual interview with the purpose to reveal how facilitating factors or barriers become apparent in the implementation of self-management practice. Integration of quantitative and qualitative data was performed to disclose a comprehensive picture of intervention effect and mechanism. Results: The pre-post HbA1c change for male subjects in the intervention group was 1.01%, which indicated a clinical significant reduction in the risk of developing stroke. At three-month post-intervention, male participants in the intervention group showed significant improvement in glycemic control (8.99% vs. 9.68%, between-group difference: 0.69±2.64, p= 0.045). Content analysis revealed that setting personally meaningful goals, making a personalized action plan, and reflecting and solution-finding were facilitating factors perceived by male subjects with poorly controlled type 2 diabetes. Two categories for barriers to optimal glycemic control were identified, including collective culture and diabetes fatalism. Conclusions: Person-centered empowerment-based intervention could facilitate male subjects with poorly controlled type 2 diabetes to actively engage in self-management activities for stroke prevention.

scholarly journals The Impact of an Internet-Based Self-Management Intervention (HeLP-Diabetes) on the Psychological Well-Being of Adults with Type 2 Diabetes: A Mixed-Method Cohort Study

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Megan Hofmann ◽  
Charlotte Dack ◽  
Chris Barker ◽  
Elizabeth Murray
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Method ◽  
Self Efficacy ◽  
Qualitative Data ◽  
Well Being ◽  
Self Management ◽  
Psychological Well Being ◽  
Management Intervention ◽  
The Impact

This mixed-method study assessed the impact of an internet-based, self-management intervention (“HeLP-Diabetes”) on the psychological well-being of adults with type 2 diabetes. Nineteen participants were recruited from 3 general practices. Data were collected at baseline and at 6 weeks follow-up. Access to HeLP-Diabetes was associated with a significant decrease in participants’ diabetes-related distress (Z=2.04,p=0.04, andd=0.28). No significant differences were found in emotional distress or self-efficacy. The qualitative data found that participants reported improvements including increased self-efficacy and support, better management of low mood, greater diabetes awareness, and taking the condition more seriously. Participants also reported making improvements to their eating habits, exercise routine, and medical management. Some negative experiences associated with using the intervention were mentioned including feelings of guilt for not using the intervention as suggested or not making any behavioral changes, as well as technical and navigational frustrations with the intervention. Internet-based self-management interventions may have the potential to decrease diabetes-related distress in people with type 2 diabetes. The qualitative data also suggests internet interventions can positively impact both psychological and behavioural outcomes of adults with type 2 diabetes.

scholarly journals Improving glycemic control in patients of South Asian origin with type 2 diabetes using a digital therapeutic (Preprint)

2020 ◽  
Author(s):  
Arjun Krishnakumar ◽  
Rajeev Chawla ◽  
Aravind Sosale ◽  
Banshi Saboo ◽  
Shilpa Joshi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
South Asian ◽  
Real World ◽  
Self Management ◽  
Post Intervention ◽  
The Mean ◽  
Program Engagement

BACKGROUND Global prevalence of type 2 diabetes (T2D), especially among South Asians, has risen alarmingly in the last decade with little improvements in glucose control. OBJECTIVE We investigated the real-world effectiveness of the Wellthy CareTM (WC) digital therapeutic in improving glycemic control among the South Asian population of Indian origin. METHODS We conducted a retrospective, real-world, observational study on 102 patients with T2D from India enrolled on a 16-week structured self-management program delivered through the WC mobile app. Patients recorded their meals, weight, physical activity, and blood sugar in the app and received coaching on self-care behaviors (healthy eating, being active, monitoring, medication adherence, problem-solving, healthy coping, and reducing risks) through structured lessons, an artificial intelligence (AI)-powered chatbot, that provided real-time feedback, and periodic, planned interactions through certified diabetes educators via voice calls and chats. The Primary outcome of the program was change in HbA1c. Secondary outcomes included, difference between the pre-and post-intervention fasting blood glucose (FBG) and postprandial blood glucose (PPBG); change in BMI and weight at the completion of 16-week program; the association between program engagement, that was measured as the total number of interactions with the health coach and the AI-powered chat-bot, and the change in HbA1c, FBG, and PPBG. RESULTS At the end of 16 weeks, the average change in HbA1c was –0.49% (95% CI −0.73 to −0.25, P < .001). Out of all the patients, 63.72% had improved HbA1c levels with the mean change being −1.16% (95% CI −1.40 to −0.92, P < .001). The mean pre-and post-intervention FBG were 145.38 mg/dl (95% CI: 135.44 to 155.33) and 134.3 mg/dl (95% CI: 122.15 to 146.54, P = .023), and PPBG was 187.84 mg/dl (95% CI: 172.47 to 203.21) and 166.36 mg/dl (95% CI: 152.83 to 179.89, P = .028). Mean change in BMI and weight was –0.47 kg/m2 (95% CI −0.22 to −0.71 kg/m2, P < 0.001), and –1.32 kg (95% CI −0.63 to −2.01 kg, P < 0.001), respectively. There was a step-wise decrease in HbA1c, FBG, and PPBG as the program engagement increased. Patients in the highest tertile of program engagement had a significantly higher reduction in HbA1c (−0.84% vs −0.06%, P = .016), FBG (−21.4 mg/dl vs −0.18 mg/dl, P = .023), and PPBG (−22.03 mg/dl vs 2.35 mg/dl, P = .0022) than those in the lowest tertile. CONCLUSIONS The WC digital therapeutic intervention is associated with improved glucose control and other health outcomes. Digital interventions could potentially help in relieving the rising diabetes burden among South Asian populations by bringing about effective behavior change and better diabetes self-management.

Lasting Effects of a Community-Based Self-Management Intervention for Patients With Type 2 Diabetes in China: Outcomes at 2-Year Follow-up of a Randomized Trial

2020 ◽  
pp. 101053952097526
Author(s):  
Yingying Jiang ◽  
Fan Mao ◽  
Wenlan Dong ◽  
Xingxing Zhang ◽  
Jianqun Dong
Keyword(s):  
Type 2 Diabetes ◽  
Self Efficacy ◽  
Intervention Group ◽  
Blood Glucose Monitoring ◽  
Self Management ◽  
Community Based ◽  
Management Intervention ◽  
Patients With Diabetes

This research is to evaluate the lasting effects of a community-based self-management intervention for patients with type 2 diabetes at 2-year follow-up in China. Five hundred patients with diabetes were recruited and randomly divided into intervention group and control group. Eight times standardized self-management intervention group activities were conducted. The results of physical examination, biochemical laboratory examination, health behavior, and self-efficacy information were collected before intervention, 3 months after intervention, and 2 years after intervention. The total score for self-efficacy in the intervention group increased from 96.12 ± 17.48 to 112.90 ± 14.58 after intervention and decreased after 2 years (106.98 ± 18.03; F = 6.64, P = .0014). The number of days of self-blood glucose monitoring in the intervention group was increased from 1 day per week to 2 days per week after intervention, and 2 days per week at 2-year follow-up ( F = 8.02, P = .0003). The frequency of average number of aerobic exercises in the intervention group increased from 6 days per week to 7 days per week after intervention and was 7 days per week at 2-year follow-up ( F = 3.63, P = .0269). Community-based self-management group intervention for patients with diabetes has long-term effects.

2180-PUB: Integration of Continuous Glucose Monitoring in Diabetes Self-Management Education for Type 2 Diabetes Improves Glycemic Control

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 2180-PUB
Author(s):  
ADDIE L. FORTMANN ◽  
ALESSANDRA BASTIAN ◽  
CODY J. LENSING ◽  
SHANE HOVERSTEN ◽  
KIMBERLY LUU ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Management Education ◽  
Glucose Monitoring ◽  
Self Management

A Prospective, Non-randomized Feasibility and Preliminary Efficacy Study of a Telemedicine-Enabled Co-management Intervention for Adults With Type 2 Diabetes and Moderate Anxiety and/or Depression

2021 ◽  
Vol 47 (2) ◽  
pp. 144-152
Author(s):  
Michelle F. Magee ◽  
Stacey I. Kaltman ◽  
Mihriye Mete ◽  
Carine M. Nassar
Keyword(s):  
Mental Health ◽  
Type 2 Diabetes ◽  
Management Program ◽  
Post Intervention ◽  
Convenience Sample ◽  
Intervention Delivery ◽  
Management Intervention ◽  
Moderate Depression ◽  
Patient Health

Purpose The primary aim of this pilot study was to examine the feasibility of codelivering a mental health intervention with an evidence-based type 2 diabetes (T2DM) boot camp care management program. The preliminary impact of participation on symptom scores for depression and anxiety and A1C was also examined. Methods This was a 12-week, non-randomized pilot intervention conducted with a convenience sample of adults with uncontrolled T2DM and moderate depression and/or anxiety at an urban teaching hospital. Co-management intervention delivery was via in-person and telehealth visits. Participants were assessed at baseline and 90 days. Results Participants (n = 18) were African American, majority female (83%), and age 50.7 ± 13.4 years. Significant improvements in mental health outcomes were demonstrated, as measured by a reduction in Patient Health Questionnaire − 9 scores of 2.4 ± 2.9 ( P = .01) and in Generalized Anxiety Disorder − 7 scores of 2.3 ± 1.9 ( P = .001). The pre-post intervention mean A1C improved by 3.4 ± 2.1 units from 12% ± 1.4% to 8.5% ± 1.7% ( P < .001). Conclusion The data generated in this pilot support the feasibility of delivering a diabetes and mental health co-management intervention using a combination of in-person and telemedicine visits to engage adults with T2DM and coexisting moderate depression and/or anxiety. Further research is warranted.

scholarly journals Self-Management Education for Adults With Type 2 Diabetes: A meta-analysis of the effect on glycemic control

Diabetes Care ◽  
2002 ◽  
Vol 25 (7) ◽  
pp. 1159-1171 ◽  
Author(s):  
S. L. Norris ◽  
J. Lau ◽  
S. J. Smith ◽  
C. H. Schmid ◽  
M. M. Engelgau
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Management Education ◽  
Meta Analysis ◽  
Self Management

scholarly journals Effectiveness of telephone interventions as a strategy for glycemic control: an integrative literature review

2013 ◽  
Vol 22 (1) ◽  
pp. 239-246 ◽  
Author(s):  
Hérica Cristina Alves de Vasconcelos ◽  
Roberto Wagner Júnior Freire de Freitas ◽  
Niciane Bandeira Pessoa Marinho ◽  
Marta Maria Coelho Damasceno ◽  
Thelma Leite de Araújo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Literature Review ◽  
Self Management ◽  
Inclusion Criteria ◽  
Adult Type ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Time Period

The objective of this study was to analyze the effectiveness of telephone interventions as a strategy for glycemic control in adult Type 2 Diabetes Mellitus patients. An integrative literature review was undertaken in April and May 2011 through surveys in the Cochrane, PubMed/Medline, Lilacs and Cinahl databases. Nine studies complied with the inclusion criteria, mainly randomized controlled clinical trials. Concerning the time period analyzed in each study, it varied from eight weeks to twelve months. 1294 patients participated in the study, being 671 randomized to telephone follow-ups and 479 to usual care. In eight studies analyzed, glycemic control was based on the levels of glycated hemoglobin (HbA1c). The information found showed that the interventions are effective for glycemic control in patients who have type 2 Diabetes. Self-management was improved and possible complications of the disease were reduced.

scholarly journals Efektivitas Mobile Health Intervention Terhadap Manajemen Diri Dan Kontrol Glikemik Pada Pasien Dengan Diabtes Melitus Tipe 2: A Systematic Review

2020 ◽  
Vol 11 (4) ◽  
pp. 342
Author(s):  
Wahyu Sukma Samudera ◽  
Novita Fajriyah ◽  
Ida Trisnawati
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Mobile Health ◽  
Controlled Trial ◽  
Health Intervention ◽  
Self Management ◽  
Diabetes Melitus

Background: Type 2 diabetes mellitus was one of non-communicable diseases that increased of prevalence in word wide, included in Indonesia. Utilization of technology as an effort of increase of diabetes treatment is important for achieving of optimum glycemic control and to prevent of complication of diabetes mellitus. However, intervention for self management in patients with diabetes mellitus at this time still not using technology based mobile health intervention. Purpose: This study aims to verify of effectiveness of mobile health intervention on self management and glycemic control in patient with type 2 diabetes mellitus. Method: Design of this studies was used systematic review of randomized controlled trial with PRISMA approach. Article search was carried out through databases: Scopus, Science Direct, and ProQuest with randomized controlled trial design within last 10 years. Results: The finding showed 407 articles have been obtained. Articles selection process were through few steps: topic selection, full text selection, design of studies and obtained 10 articles have been as appropriate of inclusion criteria. Based on results of finding of 10 articles were showed that mobile health intervention was effective in improving of glycemic control by decreasing hbA1c, fasting blood glucose, 2 hours post pandrial. Furthermore, mobile health intervention was effective in increasing of self management in patient with type 2 diabetes mellitus and increased adherence of diabetes medication. Moreover, mobile health intervention can also improve of insulin level and lipid profile in patient with type 2 diabetes mellitus. Conclusion: Mobile health intervention was effective in improving of glycemic control and self management, and giving of facilitate communication between patient and health providers Keywords: mobile health application; self management; glycemic control; diabetes mellitus ABSTRAK Latar belakang: diabetes melitus (DM) tipe 2 merupakan salah satu penyakit tidak menular yang mengalami peningkatan angka kejadian di dunia, termasuk di Indonesia. Penggunaan teknologi sebagai upaya meningkatkan manajemen diabetes melitus sangatlah penting untuk dilakukan guna mencapai kontrol glikemik optimal dan mencegah komplikasi dari Diabetes Melitus. Namun, manajemen diri pada sebagian besar pasien Diabetes Melitus saat ini masih belum menggunakan bantuan teknologi berbasis mobile health. Tujuan: Penelitian ini bertujuan untuk memverifikasi efektivitas dari penggunaan mobile health intervention terhadap manajemen diri dan kontrol glikemik pasien dengan diabetes melitus tipe 2. Metode: desain dalam penelitian ini adalah systematic review dengan menggunakan pendekatan PRISMA. Pencarian artikel dilakukan pada beberapa database yang meliputi: Scopus, Science Direct dan ProQuest dengan desain Randomized controlled trial dalam 10 tahun terakhir. Hasil: hasil temuan didapatkan sejumlah 407 artikel penelitian. Proses seleksi artikel dilakukan beberapa tahap meliputi: seleksi topik, fullteks, desain artikel penelitian dan didapatkan 10 artikel penelitian yang sesuai dengan kriteria inklusi. Berdasarkan hasil temuan dari 10 artikel penelitian yang digunakan, menunjukkan bahwa mobile health intervention efektif dalam memperbaiki kontrol glikemik pasien diabetes melalui penurunan kadar hbA1c, gula darah puasa, 2 jam post pandrial. Selanjutnya, mobile health intervention efektif dalam meningkatkan manajemen diri pasien diabetes dan meningkatkan kepatuhan pengobatan. Selain itu, mobile health intervention juga dapat memperbaiki level insulin dan profil lipid pasien diabetes melitus tipe 2. Kesimpulan: Mobile health intervention efektif dalam memperbaiki kontrol glikemik dan meningkatkan manajemen diri pasien diabetes melitus serta memudahkan komunikasi antara pasien dengan tenaga kesehatan Kata kunci: mobile health application; manajemen diri; kontrol glikemik; diabetes melitus

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