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How important is support to patients who manage their own diabetes?
Diabetes Self-Management Education and Support (DSMES) is an ongoing process that facilitates the acquisition of the knowledge, skills, and abilities necessary for the self-management of diabetes, as well as activities that help a person with diabetes. implement and maintain the behaviors necessary for its management. condition on a continuous basis, beyond or outside formal training in self-management.
Various models have been proposed to provide the necessary support for the desired improvement in diabetes knowledge and self-management skills. Community health workers, peer support and online programs can help address socioeconomic issues and facilitate navigation in the health care system.
A study by Chrvala et al. Aimed at badessing the effect of diabetes management education and support methods, providers, duration and contact time on glycemic control in adults with type 2 diabetes. interventions, with 61.9% reporting significant changes in HbA1c. The overall mean reduction in HbA1c was 0.74 and 0.17 for the intervention and control groups; an average absolute reduction of A1C of 0.57. A combination of group and individual engagement results in the largest decreases in A1C (0.88). Contact times ≥ 10 were badociated with a greater proportion of interventions with a significant reduction in HbA1c (70.3%). In patients with persistently high blood glucose values (A1C> 9), a larger proportion of studies reported a statistically significant reduction in HbA1c (83.9%).
The study concluded that the involvement in diabetes management education led to a statistically significant decrease in A1C levels. The data suggest that delivery mode, engagement times, and A1C baseline may affect the likelihood of achieving a statistically significant and clinically significant improvement in A1C levels.
Another recent study was conducted to answer the question of whether increased support for self-management of diabetes by an economically vulnerable population meets unmet need and reduces morbidity and premature mortality.
The randomized clinical trial was conducted at 4 sites. A total of 446 people have been registered. The intervention used comparisons before and after. The study was designed to test the effectiveness of a diabetes support phone intervention aimed at increasing patient participation in self-care, using the health system to improve clinical outcomes.
To be eligible, individuals had to be English-speaking or Spanish-speaking adults between the ages of 21 and 85 and be diagnosed with type 2 diabetes. The study participants had not participated in an education program related to diabetes self-management in the past year and had A1c> 8 at the time of enrollment. The subjects excluded from the study included women who were pregnant or were undergoing cancer treatment, who had end-stage renal disease or severe mental illness, or who were receiving systemic prednisone or immunosuppressive therapy after transplantation. organ.
Individuals in routine care and telephone support intervention groups showed statistically and clinically significant improvement in A1c hyperactivity after participation in this study. There have been significant improvements in screening scores for A1c, BMI, LDL, triglycerides, and depression during the year following education and training. support for the autonomous management of diabetes. However, there was no statistically significant difference in the differences between the groups for A1c, BMI, HDL, LDL, triglycerides and blood pressure. No significant changes in systolic blood pressure or diastolic blood pressure were observed after education and support for independent management of diabetes for both groups.
The study concluded that comprehensive face-to-face care, along with consistent badessment and documentation over time, has resulted in a significant improvement for people with diabetes. The addition of structured telephone support overlapping in time with the comprehensive provision of face-to-face care in this environment has not resulted in any significant improvement in clinical or behavioral care. Professionals working with people with diabetes have found value in the added connection.
Pearls of practice:
- Education and support for diabetes self-management could lead to clinically significant reductions in A1C levels, which would reduce the risk of complications.
- Delivery mode, engagement times, and A1C baseline can affect the likelihood of achieving a statistically significant and clinically significant improvement in A1C.
- Further research and research on ways to improve education and support for diabetes self-management is needed to increase understanding of approaches that will advance care.
Reference:
BM Bluml, Kolb LE, Lipman R. Evaluation of the impact of the management of the management of increased self-management of diabetes for one year. Popul Health Manag. January 22, 2019
Chrvala CA, Sherr D, Lipman RD. Autonomic Diabetes Management Education for Adults with Type 2 Diabetes: A Systematic Review of the Effect on Glycemic Control. Patient Educ Couns. 2016 June; 99 (6): 926-43.
Dahlia Elimairi, Pharmacy Student, Skaggs Pharmacy School, UC Denver
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