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Diabetes Self-Management Education: Miles to Go

This meta-analysis assessed how successfully Diabetes Self-Management Education (DSME) interventions help people with type 2 diabetes achieve and maintain healthy blood glucose levels. We included 52 DSME programs with 9,631 participants that reported post-intervention A1c levels in randomized contr...

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Detalles Bibliográficos
Autores principales: Klein, Helen Altman, Jackson, Sarah M., Street, Kenley, Whitacre, James C., Klein, Gary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616351/
https://www.ncbi.nlm.nih.gov/pubmed/23577243
http://dx.doi.org/10.1155/2013/581012
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author Klein, Helen Altman
Jackson, Sarah M.
Street, Kenley
Whitacre, James C.
Klein, Gary
author_facet Klein, Helen Altman
Jackson, Sarah M.
Street, Kenley
Whitacre, James C.
Klein, Gary
author_sort Klein, Helen Altman
collection PubMed
description This meta-analysis assessed how successfully Diabetes Self-Management Education (DSME) interventions help people with type 2 diabetes achieve and maintain healthy blood glucose levels. We included 52 DSME programs with 9,631 participants that reported post-intervention A1c levels in randomized controlled trials. The training conditions resulted in significant reductions in A1c levels compared to control conditions. However, the impact of intervention was modest shifting of only 7.23% more participants from diabetic to pre-diabetic or normal status, relative to the control condition. Most intervention participants did not achieve healthy A1c levels. Further, few DSME studies assessed long-term maintenance of A1c gains. Past trends suggest that gains are difficult to sustain over time. Our results suggested that interventions delivered by nurses were more successful than those delivered by non-nursing personnel. We suggest that DSME programs might do better by going beyond procedural interventions. Most DSME programs relied heavily on rules and procedures to guide decisions about diet, exercise, and weight loss. Future DSME may need to include cognitive self-monitoring, diagnosis, and planning skills to help patients detect anomalies, identify possible causes, generate corrective action, and avoid future barriers to maintaining healthy A1c levels. Finally, comprehensive descriptions of DSME programs would advance future efforts.
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spelling pubmed-36163512013-04-10 Diabetes Self-Management Education: Miles to Go Klein, Helen Altman Jackson, Sarah M. Street, Kenley Whitacre, James C. Klein, Gary Nurs Res Pract Research Article This meta-analysis assessed how successfully Diabetes Self-Management Education (DSME) interventions help people with type 2 diabetes achieve and maintain healthy blood glucose levels. We included 52 DSME programs with 9,631 participants that reported post-intervention A1c levels in randomized controlled trials. The training conditions resulted in significant reductions in A1c levels compared to control conditions. However, the impact of intervention was modest shifting of only 7.23% more participants from diabetic to pre-diabetic or normal status, relative to the control condition. Most intervention participants did not achieve healthy A1c levels. Further, few DSME studies assessed long-term maintenance of A1c gains. Past trends suggest that gains are difficult to sustain over time. Our results suggested that interventions delivered by nurses were more successful than those delivered by non-nursing personnel. We suggest that DSME programs might do better by going beyond procedural interventions. Most DSME programs relied heavily on rules and procedures to guide decisions about diet, exercise, and weight loss. Future DSME may need to include cognitive self-monitoring, diagnosis, and planning skills to help patients detect anomalies, identify possible causes, generate corrective action, and avoid future barriers to maintaining healthy A1c levels. Finally, comprehensive descriptions of DSME programs would advance future efforts. Hindawi Publishing Corporation 2013 2013-03-20 /pmc/articles/PMC3616351/ /pubmed/23577243 http://dx.doi.org/10.1155/2013/581012 Text en Copyright © 2013 Helen Altman Klein et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Klein, Helen Altman
Jackson, Sarah M.
Street, Kenley
Whitacre, James C.
Klein, Gary
Diabetes Self-Management Education: Miles to Go
title Diabetes Self-Management Education: Miles to Go
title_full Diabetes Self-Management Education: Miles to Go
title_fullStr Diabetes Self-Management Education: Miles to Go
title_full_unstemmed Diabetes Self-Management Education: Miles to Go
title_short Diabetes Self-Management Education: Miles to Go
title_sort diabetes self-management education: miles to go
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616351/
https://www.ncbi.nlm.nih.gov/pubmed/23577243
http://dx.doi.org/10.1155/2013/581012
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