Sustaining short-term improvements over the long-term: Results from a 2-year diabetes self-management support (DSMS) intervention

• Published in: Diabetes research and clinical practice Vol. 95; no. 1; pp. 85 - 92
• Main Authors: Tang, Tricia S, Funnell, Martha M, Noorulla, Salma, Oh, Mary, Brown, Morton B
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-01-2012
• Subjects: Adaptation, Psychological; Adult; African Americans; Aged; Aged, 80 and over; Blood Glucose - analysis; Blood Glucose Self-Monitoring; Body Weight; Cholesterol - blood; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; Diet; Empowerment; Endocrinology & Metabolism; Female; Goals; Humans; Male; Middle Aged; Patient Education as Topic; Power (Psychology); Problem Solving; Quality of Life; Self Care - methods; Self Care - psychology; Self-management; Support; Treatment Outcome; Support; Self-management; Empowerment
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2011.04.003

Abstract Aim This study examined the long-term impact of a 24-month, empowerment-based diabetes self-management support (DSMS) intervention on sustaining health-gains achieved from previous diabetes self-management education (DSME). Methods Prior to the intervention, all participants received 6 months of mailed DSME consisting of weekly educational newsletters coupled with clinical feedback. The intervention consisted of 88 weekly group-based sessions that participants were encouraged to attend as frequently as they needed. Sessions were guided by participants’ self-management questions and also emphasized experiential learning, coping, goal-setting, and problem-solving. Baseline, 6-month, and 30-month assessments measured A1C, weight, body mass index (BMI), blood pressure, lipids, self-care behaviors, and QOL. Results This report is based on 60 African-American adults with type 2 diabetes ( n = 89 recruited at baseline) who completed the study. Post 6-month DSME, participants demonstrated significant improvements for diastolic BP ( p < 0.05), serum cholesterol ( p < 0.001), healthy diet ( p < 0.01), blood glucose monitoring ( p < 0.05) and foot exams ( p < 0.01). Post 24-month intervention, participants sustained the improvements achieved from the 6-month DSME and reported additional improvements for healthy diet ( p < 0.05), carbohydrate spacing ( p < 0.01), insulin use ( p < 0.05), and quality of life ( p < 0.05). Conclusions Findings suggest that an empowerment-based DSMS model can sustain or improve diabetes-related health gains achieved from previous short-term DSME.