M C De la Fuente Coria1, C Cruz-Cobo2, M J Santi-Cano3. 1. Primary Health Care District of Bay of Cádiz-La Janda, Andalucía, Spain. Electronic address: delafuentecoriam@yahoo.es. 2. Faculty of Nursing and Physiotherapy, University of Cádiz, Spain. Electronic address: celia.cruz@uca.es. 3. Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Avda. Ana de Viya, 52, 11009 Cádiz, Spain. Electronic address: mariajose.santi@uca.es.
Abstract
BACKGROUND: Systematic reviews and meta-analyses have shown very different values for the effectiveness of education in type 2 diabetes mellitus. However, the achievement of therapeutic targets after educational programs has been poorly evaluated. OBJECTIVE: Evaluate the effectiveness of a structured and individualised education program for type 2 diabetes, provided by a primary care nurse, which featured educational reinforcements and family support to achieve metabolic control, and long-term therapeutic targets. METHODS: Randomised controlled clinical trial with two arms: Intervention and control group. The intervention consisted of six face-to-face sessions of 30 min and follow-ups after 12 and 24 months for 236 participants with type 2 diabetes mellitus in a primary care setting in Andalusia (Spain). The primary outcome variables were the values and achievement of the type 2 diabetes mellitus control targets established by the American Diabetes Association: Glycated haemoglobin, fasting blood glucose, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, triglycerides, systolic and diastolic blood pressure. The secondary outcome variable was body mass index. RESULTS: From an overall total of 236 participants, 54.2% were male and the average age was 65.1 ± 9.5. After 12 months, the glycated haemoglobin level and systolic blood pressure decreased in the intervention group. After 24 months, the following variables significantly improved among the intervention group participants: basal glycemia, glycated haemoglobin, total cholesterol low-density lipoprotein cholesterol, and diastolic blood pressure. The glycated haemoglobin target (<7%) was better achieved in the intervention group than in the control group (35.2% vs 24.7%, p < 0.003). The rest of the targets were not met. CONCLUSION: Continual diabetes education with reinforcement sessions provided by a nurse achieved reductions in glycated haemoglobin, basal glycaemia, total cholesterol, low-density lipoprotein-cholesterol and systolic blood pressure in both the medium and long term. It also increased the proportion of participants who achieved the therapeutic target of glycated haemoglobin.
RCT Entities:
BACKGROUND: Systematic reviews and meta-analyses have shown very different values for the effectiveness of education in type 2 diabetes mellitus. However, the achievement of therapeutic targets after educational programs has been poorly evaluated. OBJECTIVE: Evaluate the effectiveness of a structured and individualised education program for type 2 diabetes, provided by a primary care nurse, which featured educational reinforcements and family support to achieve metabolic control, and long-term therapeutic targets. METHODS: Randomised controlled clinical trial with two arms: Intervention and control group. The intervention consisted of six face-to-face sessions of 30 min and follow-ups after 12 and 24 months for 236 participants with type 2 diabetes mellitus in a primary care setting in Andalusia (Spain). The primary outcome variables were the values and achievement of the type 2 diabetes mellitus control targets established by the American Diabetes Association: Glycated haemoglobin, fasting blood glucose, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, triglycerides, systolic and diastolic blood pressure. The secondary outcome variable was body mass index. RESULTS: From an overall total of 236 participants, 54.2% were male and the average age was 65.1 ± 9.5. After 12 months, the glycated haemoglobin level and systolic blood pressure decreased in the intervention group. After 24 months, the following variables significantly improved among the intervention group participants: basal glycemia, glycated haemoglobin, total cholesterol low-density lipoprotein cholesterol, and diastolic blood pressure. The glycated haemoglobin target (<7%) was better achieved in the intervention group than in the control group (35.2% vs 24.7%, p < 0.003). The rest of the targets were not met. CONCLUSION: Continual diabetes education with reinforcement sessions provided by a nurse achieved reductions in glycated haemoglobin, basal glycaemia, total cholesterol, low-density lipoprotein-cholesterol and systolic blood pressure in both the medium and long term. It also increased the proportion of participants who achieved the therapeutic target of glycated haemoglobin.
Authors: Gustavo Roberto Villas Boas; João Marcos Rodrigues Lemos; Matheus William de Oliveira; Rafael Claudino Dos Santos; Ana Paula Stefanello da Silveira; Flávia Barbieri Bacha; Caren Naomi Aguero Ito; Ediane Bortolotte Cornelius; Fernanda Brioli Lima; Andrea Marisa Sachilarid Rodrigues; Nathália Belmal Costa; Felipe Francisco Bittencourt; Fernando Freitas de Lima; Marina Meirelles Paes; Priscila Gubert; Silvia Aparecida Oesterreich Journal: PLoS One Date: 2020-01-08 Impact factor: 3.240
Authors: Julia Simões Corrêa Galendi; Renata Giacomini Occhiuto Ferreira Leite; Luísa Rocco Banzato; Vania Dos Santos Nunes-Nogueira Journal: Int J Environ Res Public Health Date: 2022-04-02 Impact factor: 3.390