Nurse-led theory-based educational intervention improves glycemic and metabolic parameters in South Asian patients with type II diabetes: a randomized controlled trial.

Abstract

This study assessed whether a structured nurse-led diabetes educational program underpinned by the theories of the health belief model, change in locus of control, and patient empowerment is effective in improving glycemic and metabolic parameters among South Asians with type II diabetes compared to regular outpatient care. This was a parallel-group randomized trial in South Asian adult patients with type II diabetes living in Qatar. 460 subjects were randomized to a nurse-led, group-based diabetes educational program (n=230) or to usual care (n=230). The primary outcome was the improvement in HbA1c and other metabolic parameters, including lipid profile, albumin/creatinine ratio, blood pressure, and body mass index. Patients in the intervention group were invited to attend four 2-h sessions of self-efficacy improvement education once weekly. Outcomes were assessed at baseline and 12months later. An intention-to-treat analysis was performed using repeated measures ANOVA (analysis of variance) for each of the clinical outcome variables. After 12months, 290 patients completed the study. Subjects in the intervention group had statistically significant improvements in HbA1c (-0.55%, p=0.012), fasting blood sugar (-16.6mg/dl, p=0.022), albumin/creatinine ratio (-3.09, p<0.001), and HDL cholesterol (+6.08mg/dl, p<0.0001). The inclusion of South Asian patients with type II diabetes in a structured, theory-based diabetes educational program that is led by nurses improves glycemic and metabolic parameters after 12months.