scholarly journals Glycaemic benefit of structured diabetes education in Nepal, a resource limited environment

2020 ◽  
Vol 20 (2) ◽  
pp. 107-112
Author(s):  
Jaya Pradhan ◽  
Satyan M Rajbhandari

Introduction: Structured diabetes education is a key element in the management of type 2 diabetes, but this is challenging to deliver in settings where resources are limited.Methods: We conducted a randomised evaluation of a single 90-minute session of structured diabetes education added to the local standard of diabetes care compared with a control group (standard diabetes care only) in 150 patients with recently diagnosed type 2 diabetes in Nepal. The level of knowledge about diabetes was low.Results: Follow-up 6 months after the intervention showed that the reduction in mean (SD) fasting plasma glucose was significantly larger in the education group (from 8.6 (2.9) mmol/L to 6.7 (1.2) mmol/L) compared with the control group (from 8.1 (1.8) mmol/L to 7.0 (1.8) mmol/L) (p=0.029 for comparison between groups). A significant reduction in postprandial plasma glucose also occurred in the education group (from 11.7 (3.7) mmol/L to 8.3 (1.2) mmol/L) compared with the control group (from 11.5 (4.0) mmol/L to 9.7 (2.3) mmol/L) (p=0.005 between groups). A trend to reduced HbA1c was seen for the education versus the control group at 6 months (p=0.06). There were no significant changes in lipids or blood pressure. Overall energy intake and the proportion of energy intake from fat was lower at 6 months compared with baseline for the education group but not for the control group, although there were no significant changes in anthropometric parameters.Conclusion: Our results suggest that a single session of structured diabetes education may provide glycaemic benefits in newly-diagnosed type 2 diabetes patients, and that this may be a pragmatic means of improving diabetes self-care in resource-limited countries such as Nepal.

2019 ◽  
Vol 26 (2) ◽  
pp. 185-198
Author(s):  
Cornelia Bala ◽  
Adriana Rusu ◽  
Mihaela Moise ◽  
Gabriela Roman

Abstract Background: Basal-EDUC-RO Study evaluated the impact of structured education provided at the initiation of basal insulin therapy on glycaemic control in patients with uncontrolled type 2 diabetes mellitus (T2D). Methods: This was a prospective, multicenter, randomized, parallel group study (ACTRN12616001273471) which enrolled 711 patients initiated on insulin therapy with a basal insulin analogue. The subjects were randomized (1:1) to either structured education (structured education group; 353 patients) or standard education (control group; 358 patients) and followed for 6 months. Results: The median HbA1c levels at 6 months after start of basal insulin were significantly lower in the structured education group than in the control group (7.2% vs. 7.4%, p <0.001). In the structured education group, 49.4% of subjects achieved HbA1c targets vs. 34.4% in the control group, p <0.001. Number of documented symptomatic hypoglycemic episodes (all and nocturnal) was lower in the intervention group (139 vs. 217 for all episodes and 13 vs. 26 for nocturnal hypoglycemia) but with no statistical significance. No effect of intervention was seen on body weight, but there was no weight gain in any of the groups at 6 months. Conclusions: A structured diabetes education program delivered to patients with T2D started on a basal insulin analogue significantly improved glucose control at 6 months compared to a less intense education strategy. The positive effect was mainly seen on the percentage of patients who achieved individualized HbA1c pre-set targets, with a non-significant reduction in episodes of overall and nocturnal documented symptomatic hypoglycemia.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 772-P
Author(s):  
MARIKO HIGA ◽  
AYANA HASHIMOTO ◽  
MOE HAYASAKA ◽  
MAI HIJIKATA ◽  
AYAMI UEDA ◽  
...  

Author(s):  
Emina Hadziabdic ◽  
Sara Pettersson ◽  
Helén Marklund ◽  
Katarina Hjelm

Abstract Aim: To develop a diabetes education model based on individual beliefs, knowledge and risk awareness, aimed at migrants with type 2 diabetes, living in Sweden. Background: Type 2 diabetes is rapidly increasing globally, particularly affecting migrants living in developed countries. There is ongoing debate about what kind of teaching method gives the best result, but few studies have evaluated different methods for teaching migrants. Previous studies lack a theoretical base and do not proceed from the individuals’ own beliefs about health and illness, underpinned by their knowledge, guiding their health-related behaviour. Methods: A diabetes education model was developed to increase knowledge about diabetes and to influence self-care among migrants with type 2 diabetes. The model was based on literature review, on results from a previous study investigating knowledge about diabetes, on experience from studies of beliefs about health and illness, and on collaboration between researchers in diabetes care and migration and health and staff working in a multi-professional diabetes team. Findings: This is a culturally appropriate diabetes education model proceeding from individual beliefs about health and illness and knowledge, conducted in focus-group discussions in five sessions, led by a diabetes specialist nurse in collaboration with a multi-professional team, and completed within three months. The focus groups should include 4–5 persons and last for about 90 min, in the presence of an interpreter. A thematic interview guide should be used, with broad open-ended questions and descriptions of critical situations/health problems. Discussions of individual beliefs based on knowledge are encouraged. When needed, healthcare staff present at the session answer questions, add information and ensure that basic principles for diabetes care are covered. The diabetes education model is tailored to both individual and cultural aspects and can improve knowledge about type 2 diabetes, among migrants and thus increase self-care behaviour and improve health.


2002 ◽  
Vol 10 (S1) ◽  
pp. R96-R96 ◽  
Author(s):  
S. M. Aburuz ◽  
J. C. McElnay ◽  
J. S. Millership ◽  
W. J. Andrews ◽  
S. Smyth

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Fan Zheng ◽  
Suixin Liu ◽  
Yuan Liu ◽  
Lihua Deng

Objective. This study is aimed at assessing the effectiveness of a simple outpatient diabetes self-management education programme. Methods. In the study, 60 patients with type 2 diabetes mellitus were randomly allocated into the control group (n=30) and intervention group (n=30). Regular and 2-session health education programmes were provided. The summary of diabetes self-care activity measure, problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were measured before and after the intervention to assess the effects of this 2-session diabetes education programme. Results. The total mean score of the summary of diabetes self-care activities measure was 17.60±6.63 points. The problem areas in the diabetes scale revealed that the total mean score was 29.82±15.22 points; 27% of the patients had diabetes-related distress, while 9% suffered from severe emotional distress. Compared with the control group, scores of the summary of diabetes self-care activities measure and problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were significantly improved in the intervention group after the intervention (P<0.01). Conclusion. This study showed that the 2-session diabetes education programme could effectively improve the level of self-reported self-management, psychological distress, and glycemic control in patients with type 2 diabetes mellitus.


2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Masumeh Hemmati Maslakpak ◽  
Somaieh Razmara ◽  
Zahra Niazkhani

Background. Education of patients and their families is the cornerstone of effective diabetes care. The present study aimed to compare the effects of a face-to-face and telephone-based family-oriented educational program on self-care behavior and patient outcomes in type 2 diabetes patients. Methods. In the present randomized controlled trial, 90 type 2 diabetes patients were randomly divided into three groups of 30 participants: a face-to-face education group, a telephone-based education group, and a control group. The educational program lasted for 3 months. Outcomes evaluated included self-care, fasting blood sugar, hemoglobin A1c, cholesterol, and triglyceride. Results. The overall self-care scores in the intervention groups were significantly higher than that in the control group (P=0.0001). In addition, lipid profiles significantly improved in the interventions compared to the control (P<0.05). Comparing the two interventions showed better results for the face-to-face group regarding dietary adherence and physical activity, but the latter group had comparable results in blood glucose monitoring, foot care, and cholesterol level. Conclusions. This study shows the beneficiary effects of a family-oriented education on self-care and patient outcomes. It also shows the potential value of low-cost telephone technology in delivering effective diabetes care.


2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Mengyi Li ◽  
Xuemin Huang ◽  
Hui Ye ◽  
Yao Chen ◽  
Jing Yu ◽  
...  

Aims. To evaluate the efficacy and safety of mulberry twig alkaloid (SZ-A) tablet compared with acarbose in patients with type 2 diabetes.Methods. This clinical trial enrolled 38 patients who were randomized into two groups (SZ-A: 23; acarbose: 15) and were treated for 24 weeks. Patients and clinical trial staffs were masked to treatment assignment throughout the study. The primary outcome measures were glycated hemoglobin (HbA1c) and 1-hour and 2-hour postprandial and fasting plasma glucose levels from baseline to the end of treatment. Analysis included all patients who completed this study.Results. By the end of this study, HbA1c level in SZ-A group was decreased from baseline significantly (P<0.001). No significant difference was found when compared with acarbose group (P=0.652). Similarly, 1-hour and 2-hour postprandial plasma glucose levels in SZ-A group were decreased from baseline statistically (P<0.05), without any significant differences compared with acarbose group (P=0.748and 0.558, resp.). The fasting plasma glucose levels were not significantly changed in both groups. One of 23 patients in SZ-A group (4.76%) and 5 of 15 patients in acarbose group (33.33%) suffered from gastrointestinal adverse events.Conclusions. Compared with acarbose, SZ-A tablet was effective and safe in glycemic control in patients with type 2 diabetes.


2017 ◽  
Vol 32 (2) ◽  
pp. 130-142 ◽  
Author(s):  
Ruth I. Versteeg ◽  
Dirk J. Stenvers ◽  
Dana Visintainer ◽  
Andre Linnenbank ◽  
Michael W. Tanck ◽  
...  

Ambient light intensity is signaled directly to hypothalamic areas that regulate energy metabolism. Observational studies have shown associations between ambient light intensity and plasma glucose and lipid levels, but human data on the acute metabolic effects of light are scarce. Since light is the main signal indicating the onset of the diurnal phase of physical activity and food intake in humans, we hypothesized that bright light would affect glucose and lipid metabolism. Therefore, we determined the acute effects of bright light on plasma glucose and lipid concentrations in 2 randomized crossover trials: (1) in 8 healthy lean men and (2) in 8 obese men with type 2 diabetes. From 0730 h, subjects were exposed to either bright light (4000 lux) or dim light (10 lux) for 5 h. After 1 h of light exposure, subjects consumed a 600-kcal mixed meal. Primary endpoints were fasting and postprandial plasma glucose levels. In healthy men, bright light did not affect fasting or postprandial plasma glucose levels. However, bright light increased fasting and postprandial plasma triglycerides. In men with type 2 diabetes, bright light increased fasting and postprandial glucose levels. In men with type 2 diabetes, bright light did not affect fasting triglyceride levels but increased postprandial triglyceride levels. We show that ambient light intensity acutely affects human plasma glucose and triglyceride levels. Our findings warrant further research into the consequences of the metabolic effects of light for the diagnosis and prevention of hyperglycemia and dyslipidemia.


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