Poorly Controlled Diabetes Benefits From Interventions

Patients with poorly controlled diabetes benefit from behavioral, educational interventions

THURSDAY, Oct. 13 (HealthDay News) -- Behavioral and educational interventions effectively improve glycemic control for patients with poorly controlled diabetes, according to three studies published online Oct. 10 in the Archives of Internal Medicine.

Katie Weinger, Ed.D., from the Joslin Diabetes Center in Boston, and colleagues investigated the efficacy of a behavioral intervention for improving glycemia in long-duration, poorly controlled diabetes. Participants were randomized to a structured behavioral group, a group control, or an individual control for six months. The structured behavioral group showed significantly greater improvement in three-month hemoglobin A1c (HbA1c) concentration changes. Participants with type 2 diabetes experienced greater improvement than those with type 1 diabetes.

In a second study, Dominick L. Frosch, Ph.D., from Palo Alto Medical Foundation Research Institute in California, and colleagues randomly assigned socially and economically disadvantaged patients to an intervention package of video behavior support with a workbook and telephone coaching or to use a 20-page brochure developed by the National Diabetes Education Program. There was a significant overall reduction in mean HbA1c from baseline to six months, but the between-group differences were not significant. In a third study, JoAnn Sperl-Hillen, M.D., from the HealthPartners Medical Group in Minneapolis, and colleagues compared group and individual education with usual care for patients with type 2 diabetes and HbA1c of 7 percent or higher. The mean HbA1c concentration decreased in the treatment groups, but significantly more so in those receiving individual education rather than group education.

"Individual education for patients with established suboptimally controlled diabetes resulted in better glucose control outcomes than did group education," Sperl-Hillen and colleagues conclude.

One author from the Weinger study disclosed financial ties to the pharmaceutical industry. Two authors from the Frosch study disclosed ties to the Foundation for Informed Medical Decision Making, which developed the DVD evaluated in the study. Several authors from the Sperl-Hillen study disclosed financial ties to pharmaceutical companies, including Merck, which funded the study.

Abstract - Weinger
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Abstract - Frosch
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Abstract - Sperl-Hillen
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