R Jayasuriya1, M J Pinidiyapathirage2, R Jayawardena3, A Kasturiratne4, P de Zoysa5, P Godamunne6, S Gamage7, A R Wickremasinghe4. 1. School of Public Health & Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: r.jayasuriya@unsw.edu.au. 2. School of Public Health & Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia. 3. Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. 4. Department of Public Health, University of Kelaniya, Faculty of Medicine, Ragama, Sri Lanka. 5. Faculty of Medicine, University of Colombo, Colombo 9, Sri Lanka. 6. Medical Education Centre, University of Kelaniya, Faculty of Medicine, Ragama, Sri Lanka. 7. Department of Psychiatry, University of Peradeniya, Peradeniya, Sri Lanka.
Abstract
AIMS: The study tested the hypothesis that a theory driven Diabetes Self-Management (DSM) intervention delivered by trained nurses would result in a clinically significant improvement in glycaemic control. METHODS:Patients with an HbA1c >7.5% (58mmol/mol) and free of diabetes complications were enrolled into a randomized controlled trial (n=85). Intervention consisted of four sessions and monthly follow up for 6 months. Biochemical tests, and diet and physical activity assessments were done in both groups. Analysis of covariance was used to test the effectiveness of the intervention. RESULTS: At 6 months, there was a significant difference (P=0.001) in HbA1c between the groups controlling for baseline values and other variables. Based on the primary outcome, 28% in the intervention group achieved the target value of 6.5% HbA1c, compared to 8% in the "usual care" group (P<0.001; η(2)=0.65). The reduction in total energy intake and increase in physical activity was significant in the intervention group between baseline and follow up. CONCLUSIONS: The DSM intervention has resulted in a clinically significant impact on glycaemia, change in diet and physical activity, and has demonstrated the feasibility of using it within existing care arrangements in a developing country setting.
RCT Entities:
AIMS: The study tested the hypothesis that a theory driven Diabetes Self-Management (DSM) intervention delivered by trained nurses would result in a clinically significant improvement in glycaemic control. METHODS:Patients with an HbA1c >7.5% (58mmol/mol) and free of diabetes complications were enrolled into a randomized controlled trial (n=85). Intervention consisted of four sessions and monthly follow up for 6 months. Biochemical tests, and diet and physical activity assessments were done in both groups. Analysis of covariance was used to test the effectiveness of the intervention. RESULTS: At 6 months, there was a significant difference (P=0.001) in HbA1c between the groups controlling for baseline values and other variables. Based on the primary outcome, 28% in the intervention group achieved the target value of 6.5% HbA1c, compared to 8% in the "usual care" group (P<0.001; η(2)=0.65). The reduction in total energy intake and increase in physical activity was significant in the intervention group between baseline and follow up. CONCLUSIONS: The DSM intervention has resulted in a clinically significant impact on glycaemia, change in diet and physical activity, and has demonstrated the feasibility of using it within existing care arrangements in a developing country setting.
Authors: T N Anand; Linju Maria Joseph; A V Geetha; Dorairaj Prabhakaran; Panniyammakal Jeemon Journal: Lancet Glob Health Date: 2019-06 Impact factor: 38.927
Authors: Joseph Linju Maria; T N Anand; Boban Dona; Jose Prinu; Dorairaj Prabhakaran; Panniyammakal Jeemon Journal: Lancet Glob Health Date: 2020-11-23 Impact factor: 26.763