Diabetes Self-care Education Research Articles

THE EFFECT OF STRUCTURED DIABETIC SELF-CARE EDUCATION ON GLYCAEMIC CONTROL AMONG ADULTS WITH TYPE-2 DIABETES: A RANDOMIZED CONTROLLED CLINICAL TRIAL

In Sub-Sahara Africa, diabetes is adversely reducing life expectancy partially due to inadequate diabetes self-care practice. Numerous folks with diabetes lack the requisite skills and knowledge to effectively manage their own condition. This study determined the effectiveness of a structured diabetes self-care education (DSCE) intervention versus routine care on glycaemic control among adults with type-2 diabetes attending a Family Medicine Clinic.We offered a DSME intervention and assessed how it affected patients’ self-reported levels of diabetes knowledge, glycosylated haemoglobin (HbA1C) and diabetes self-care activities. Overall, there was poor diabetes knowledge at baseline (7.29 ± 2.81) among study participants. The difference in the mean Diabetes Knowledge scores before and after the DSME intervention was significantly greater in the intervention arm (mean difference = 13.29; 95% CI = 12.78 – 13.79; p <0.001). Both groups showed improvement in mean glycosylated haemoglobin from baseline to post intervention however, the mean difference (2.04%) between the intervention and the routine care groups was statistically significant (95% CI = 2.35 – 3.73; p <0.0001).Our study found significant improvements among the intervention group. The DSME tool impact positively on participants’ diabetes knowledge scores. Hence, our DSME intervention is clinically useful in diabetes mellitus self care.

PENGARUH DIABETES SELF CARE MANAGEMENT EDUCATION TERHADAP PENGETAHUAN PENDERITA DIABETES MELITUS TIPE 2 DI WILAYAH KERJA PUSKESMAS PARIAMAN

Diabetes mellitus (DM) is now growing into a global health problem, its prevalence in 2019 was 371 million cases and is predicted to increase by 55 percent to 592 million in 2035. The purpose of the study was to determine the effect of diabetes self-care management education on the knowledge of Type 2 Diabetes Mellitus sufferers in the Pariaman Health Center Work Area, Pariaman City. The type of quasi-experimental research with one group pretest posttest design. Sampling was carried out using the total sampling technique, namely 36 respondents. The data collection tool used was a questionnaire filled in by the researcher and data processing was carried out using a computerized system. The results showed that most of the respondents (61.1%) had a low level of knowledge before being given diabetes self-care management education. Almost all respondents (86.1%) experienced an increase in their knowledge after being given diabetes self-care management education. Statistical analysis showed that there was an effect of diabetes self-care management education on increasing knowledge in type 2 diabetes mellitus sufferers in the Pariaman Health Center Work Area (p-value = 0.000 <0.05). In conclusion, providing diabetes self-care management education increases the knowledge of type 2 diabetes mellitus sufferers in the Pariaman Health Center Work Area.

An intervention to improve self-care among people with diabetes mellitus: A quasi-experimental study

Abstract Background An increased self-efficacy promotes better diabetes self-care behaviours, which help in achieving glycemic targets among patients with diabetes mellitus. Methods A quasi-experimental study was conducted among patients with T2DM living in rural areas of Punjab, North India. A total of 283 in the intervention and 291 in the control arms were participated at baseline, and a total of 242 in the intervention and 237 in the control arms at endline assessments. Summary of diabetes self-care activities and diabetes management self-efficacy questionnaires were used at baseline and endline (after 6 months) surveys. Outcomes were net changes in proportion of population having diabetes self-management self-efficacy, overall diabetes self-care activities (health dietary habits, physical activity, adequate foot care, medication adherence and blood glucose monitoring) and net mean change in HbA1c. Data were analysed using per protocol analysis principle. Difference in difference analysis (DiD) using Generalized Estimating Equation model was done to adjust for confounders. p < 0.05 was considered as significant. Results There was a significant net increase in participants proportion (39%; 95% CI: 25% -52%, p < 0.001) on diabetes management self-efficacy scale. At the baseline assessment for overall self-care behaviours, only 4% of participants in the intervention arm were in the action stage and 12% were in the preparation stage; however, at the post intervention assessment, this proportion increased to 24% for action stage and 67% for preparation stage. There was a significant net increase in participants proportion (49%, 95%CI 37% -60%, p < 0.001) engaged in optimal diabetes self-care. There was a significant net decrease in mean HbA1c (-1.06%; 95%CI: -1.62 - -0.50, p < 0.001) at post intervention phase. Conclusions Diabetes self-care intervention was successful in promoting self-efficacy and self-care practices among patients with T2DM of rural areas. Key messages • Self-efficacy theory-based diabetes self-care intervention successfully improves the diabetes related self-care practices. • There is a need for a structured diabetes self-care management education programme to improve the ability of patients with T2DM who live in rural areas.

Cultural-Based Diabetes Self-Care Management Education for People with Type 2 Diabetes Mellitus: Empowering Community Health Workers (Kaders) Program Evaluation

Aim: The aim of this study was to understand the perspectives of Kaders, community health nurses (CHNs), and the community on an empowerment program for Kaders in Indonesia. The program aimed to help Kaders provide cultural-based diabetes self-care management education for people with type 2 diabetes mellitus (T2DM). Methods: The empowerment program consisted of a four-month training program, including two full-day sessions on cultural-based health education for people with T2DM, followed by four months of monitoring T2DM patients. Fifteen Kaders from community health centers in Makassar City participated in the program. Focus group discussions (FGDs) were conducted with Kaders to explore their perceptions and experiences related to the program. Interviews were also conducted with CHNs and people with T2DM regarding their perceptions of the program. Results: The FGDs with Kaders resulted in four themes: overall training, guideline book, education and monitoring program, and potential obstacles. CHNs highlighted the benefits of the program, the guideline book, and the impact on patients. Patients identified three themes, including the benefits of the program, what was taught, and what was improved. Conclusion: The empowerment program for Kaders in Indonesia has proven to be beneficial for Kaders, CHNs, and the community. Kaders have the potential to provide effective and efficient health education with proper preparation and empowerment through knowledge and skills.

32-LB: Oral Care Behaviors among the U.S. Population with Diabetes

Diabetes self-care skills are necessary to control glucose in people with diabetes (PWD). The ADA recommends self-care behaviors including healthy eating, being active, monitoring, taking medication, consulting diabetes care professionals, and reducing risk for complications. Oral self-care is an important but often overlooked aspect of reducing risk in diabetes self-care. This study examined the relationship between diabetes self-care and oral care behaviors. Using NHANES 2011-2016, we analyzed data from 1,585 dentate adults (≥ 30yrs) with self-reported diabetes. Oral self-care was measured by use of preventive dental care in the past year and flossing frequency (never, 1-6day/week, daily). Descriptive analyses compared people reporting good diabetes self-care (score 4-7, summary score of 7 self-care recommendations) and those with poor diabetes self-care (score 0-3), an approximate median split. Sample weights were applied to derive US population estimates. Multivariable and multinomial logistic regression was performed adjusting for age, gender, race, education, income and health insurance. Among the US PWD, 35% report daily flossing and 29% report never flossing; 48% reported a preventive dental visit in the past year. PWD who performed good diabetes self-care were 47% more likely to report using preventive dental care compared to those with poor diabetes self-care (AOR=1.47, 95%CI 1.18-1.84), and they were 38% more likely to be flossing daily (AOR=1.38, 95%CI 1.07-1.79). PWD who practice good diabetes self-care are more likely to also engage in good oral self-care. However, the association cannot be attributed to diabetes self-management education because until 2023, the ADA standards for diabetes self-management did not address oral health practices or dental care. Continued efforts are needed to incorporate oral self-care practices into diabetes self-care education. Further research is warranted to determine possible disparities in diabetes self-management and oral care. Disclosure Y. Zhang: None. S. Leveille: None. K. Berger: None. S. M. Camhi: None. L. Shi: None.

The Effect of Flipped Learning Method on Self-care of Patients with Type 2 Diabetes

Background: One of the reasons for the lack of success and desired treatment results in diabetic patients is their lack of participation in treatment. Diabetes self-care education is a key factor in the prevention and treatment of diabetes, which is effective in improving the patient’s quality of life (QoL) and cost reduction. Objectives: This study aimed to determine the effect of the flipped learning method on the self-care of patients with type-2 diabetes referred to the Diabetes Clinic of Bu-Ali Hospital in Zahedan. Methods: A semi-experimental study was conducted on 114 diabetic patients. The participants were randomly divided into intervention and control groups, and a pre-test was administered. The self-care of diabetes index (SCODI), 40 items, was completed before and after the intervention by the research samples. The flipped learning program was conducted as an intervention in five sessions for patients in the intervention group, and a post-test was administered two months after the completion of the educational intervention. The obtained data were analyzed by SPSS 26. The significance level was considered less than 0.05. Results: Two months after the flipped learning intervention, the findings showed more positive changes in the flipped learning method in increasing the patients’ self-care in the intervention group (P > 0.001). The mean score of self-care and its variations mean was significantly higher in the intervention group in the post-test than in the control group (P = 0.001). Conclusions: Implementing flipped learning positively affects increasing self-care in diabetic patients. It seems that the implementation of such programs can play an effective role in the treatment and prevention of type-2 diabetes complications.

The Effect of Culturally Appropriate Self-Care Intervention on Health Literacy, Health-Related Quality of Life and Glycemic Control in Iranian Patients with Type 2 Diabetes: A Controlled Randomized Clinical Trial.

Cultural and language differences are necessary factors for diabetes management and self-care education programs in patients suffering from diabetes. This study aims to investigate the effectiveness of culture-based self-care intervention on health literacy, quality of life, and glycemic parameters in patients with type 2 diabetes. This randomized clinical trial has been carried out in selected centers in Darreh Shahr, Iran; 80 participants were randomly assigned into intervention and control groups. The intervention group received an educational program for 6 sessions twice a week, but the control group only received routine services. Data were collected using health literacy and life quality scales for diabetic patients, which were completed by both groups before, immediately after, and 3 months after the intervention; hemoglobin A1C (HbA1c) was checked before and 3 months after the intervention. SPSS software was also analyzed data using χ2, Fisher's exact, independent t, and repeated measures analysis of variance tests. There were no significant differences between the 2 groups before the study (p >0.05) goes forward. But, mean scores of health literacy (F2,40 = 5.61, p =0.007), quality of life (F2, 40 = 4.09, p =0.01), and HbA1c levels (t, 39 = 6. 91, p <0.001) have shown significant differences between the 2 groups immediately and 3 months after the intervention have been applied. Culturally appropriate intervention should be offered as a part of the nurse' care program for diabetic to control HbA1c, and improve their life quality and health literacy.

The Effect of Diabetes Self-care Education through WhatsApp Virtual Messenger on the Self-care Behavior of Patients with Type 2 Diabetes: A Semi-experimental Study

Background and Objective: Immediate interventions are necessary to improve the self-care behaviors of diabetic patients. This study aimed to investigate the effect of diabetes self-care education through WhatsApp virtual messenger on the self-care behavior of diabetic patients. Materials and Methods: This semi-experimental study was conducted in Jiroft, Iran, in 2019, and included 96 patients with type 2 diabetes who met the inclusion criteria and were selected randomly and divided into intervention and control groups using simple random allocation (lottery). The educational content of self-care was sent to the intervention group by the researcher for 8 sessions of 60 minutes (2 sessions per week) through the WhatsApp virtual messenger. Summary of Diabetes Self Care Activities questionnaire was completed in two stages before and one month after the end of the intervention in both groups. The obtained data were analyzed in SPSS software (version 24) through descriptive (Mean±SD) and inferential statistics (ANCOVA). Results: Before and one month after the intervention, the overall score of self-care behaviors and the scores of such subscales as diet adherence, foot care, blood sugar control, and regular medication use, increased significantly in the intervention group (P&lt;0.001); however, there was no significant change in the overall score of self-care behavior and its subscales in the control group (P&gt;0.05). Conclusion: Implementation of the self-care education program through WhatsApp virtual messenger helps to improve the self-care behaviors of diabetes patients and can be used as an effective method in preventing the adverse consequences of diabetes.

Impact of Pharmacist-Led Diabetes Self-Care Education on Patients With Type 2 Diabetes in Pakistan: A Randomized Controlled Trial.

Introduction: There is a little evidence on efficacy of pharmacy-based interventions on clinical outcomes of type 2 diabetes mellitus (T2DM) patients in Pakistan. Objective: To appraise the impact of pharmacist-led self-care education on glycemic control, self-care practices and disease knowledge of T2DM patients with poor glycemic control (HbA1c ≥ 7%). Methods: In this 6-months, randomized controlled trial (RCT), n = 75, T2DM patients seeking care at a diabetes clinic were randomized in to two groups. Intervention group (n = 38) received two face-to-face educational sessions (at enrollment and on week 12), whereas control group (n = 37) received usual care. Outcome measures such as glycemic control, self-care practices and disease knowledge were assessed at the time of enrollment and after 6-months in both groups. Results: Thirty-three intervention and thirty-three participants from the control group completed the study. Mean glycated hemoglobin (% HbA1c) significantly reduced in the intervention group from 9.00 ± 1.43 to 8.09 ± 1.16 (p < .01). However, no significant change was observed in the control group (9.20 ± 1.24 to 8.93 ± .97; p = .06). Cohen’s d effect size of the intervention on HbA1c was .78. Percentage of participants achieving glycemic control (HbA1c < 7%) were significantly higher (p < .05) in the intervention group as compared to the control group (twenty-four vs. six), after 6 months of the trial. A significant (p < .01) improvement in mean scores for disease knowledge and self-care activities was also observed in the intervention group participants, whereas no significant improvements (p > .05) were observed in the control group. Conclusion: The study demonstrated an improvement in glycemic control, disease knowledge and self-care activities of T2DM patients who received pharmacist-led educational intervention. The study findings support clinical significance of integrating pharmacy-based interventions in diabetes management.

Effectiveness of diabetes self-care education at primary health care centres in Saudi Arabia: A pragmatic randomized trial in Tabuk.

Objective:The present trial aimed to assess the effectiveness of the structured Information, Education, and Communication provided by trained health educators at primary care on the mean body mass index, waist circumference, fasting blood glucose, and the level of blood pressure, among patients with type 2 diabetes mellitus.Research Methods:This was a 12-month pragmatic clustered randomized trial where 180 patients with type 2 diabetes mellitus were enrolled in 2020. Five primary health care centres were randomly allocated to either the intervention or control arm.Results:There was a comparable significant reduction in the mean scores of waist circumference among participants in the intervention versus control arm over 12 months: I =108.7:C = 85.8 cm (P value = 0.001), I = 109.2:C = 86.02 cm (P value = 0.001), and I = 105.6:C = 87.2 cm (P value = 0.001) in the first, sixth, and twelfth months, respectively. A significant reduction in the mean scores of body mass index in the intervention versus control arm only in the first month: I =31.7:C = 26.5 cm (P value = 0.001). However, there was a comparable significant reduction in the mean scores of fasting blood glucose in the intervention versus control arm over 12 months: I =2016.5:C = 185.3 mmol/l (P value = 0.011), I = 207.4:C = 168.04 mmol/l (P value = 0.002), and I = 2012.7:C = 158.6 mmol/l (P value = 0.001) in the first, sixth, and twelfth months, respectively.Conclusions:The delivery of structured diabetes self-care education for diabetics by trained health educators at primary health care has a beneficiary effect on reducing the mean body mass index, waist circumference, and blood glucose. Similarly, it decreases high blood pressure.

Factors influencing adherence to self-care practices among patients of type 2 diabetes mellitus from Saurashtra region of Gujarat: A conclusive research.

It is commonly understood that diabetes self-care practice is critical in the management of the disease. However, the magnitude and determinants of self-care practices are not well evaluated at the community level. A community based cross-sectional study was conducted among 178 type 2 DM patients. Self-care practices were evaluated for the last seven days and each item was scored from 0 (none of the days in a week) to 7 (all 7 days were followed). Adherence to medication (89.3%) and blood glucose monitoring (65.2%) were relatively higher than other domains. Factors associated with dietary adherence were secondary level education and above (OR = 22.1, 95% CI = 6.85 to 71.3), physician or endocrinologist treating doctors (OR = 3.36, 95% CI = 1.24 to 11.32), joint and three-generation family (OR = 3.32, 95% CI = 1.23 to 8.92) and upper and middle socioeconomic class (OR = 2.5, 95% CI = 1.1 to 6.2). Good glycemic control was significantly associated with dietary adherence (OR = 6.81, 95% CI = (2.71 to 17.16), medication adherence (OR = 4.59, 95% CI = 1.3 to 16.24) and regular exercise (OR = 3.65, 95% CI = 1.62 to 8.19). There is need to develop structured diabetes self-care education programs with involvement of private practitioners as a majority of the patients consult private practitioners for treatment. Health educators might have to place emphasis on self-care education to patients as well as caregivers belonging to low socioeconomic class and having lower education.

Effectiveness of Diabetes Self-management Education Against Diet Behavior in Patients Type 2 Diabetes Mellitus: A Literature Review

BACKGROUND: Diabetes mellitus (DM) is a disease that describes a problem with insulin deficiency and the inability of the pancreas to produce enough insulin. The World Health Organization predicts that the number of people with DM type II in Indonesia will increase to 12 million by 2030. AIM: This study looks at Journals on diabetes selfmanagement education (DSME) on DM patients in improving dietary behavior. METHODS: This study uses an online journal database that provides free articles and journals in PDF such as: ProQuest, EBCSO, PubMed, Elsevier, Scinapse, MDPI, and Google Scholar. Literature was collected from the past 10 years, namely, 2010–2020 using the following set of keywords: “DSME,” “DSME Program Evaluation,” and “Diabetes Self-Care Education.” RESULTS: DSME intervention can improve the condition of DM patients if it is routinely carried out. In addition, the DSME intervention was able to control hemoglobin A1c levels and control blood sugar. This intervention still needs to be developed, considering that various forms of education in DM patients have been carried out such as using text messages, leaflets, illustrated pictures or leaflets, by telephone, video, handbooks, or direct education. These investigations can be developed into empirical research. CONCLUSIONS: The application of DSME interventions can help improve the conditions experienced by DM type II sufferers if it is routinely carried out.

The role of diabetes self-care education and practice in the management of type 2 diabetes mellitus (T2DM)

The role of diabetes self-care education and practice in the management of type 2 diabetes mellitus (T2DM)

Effectiveness Diabetes Self Care Management Education (DSME) intervention with Short Message Service (SMS) or Mobile Application in Glycemic Control: A Systematic Review

Introduction: Glycemic control in DM is responsive to the condition of patients who have hemoglobin A1c (HbA1c) levels of 5-6%. However, most patients find it difficult to achieve the target of glycemic control. Diabetes Self-Management Education (DSME), which integrates the five pillars of DM management, emphasizes intervention behavior independently. The purpose of this systematic review is to analyze the effectiveness of diabetes self-management education intervention with short message service (SMS) or mobile application on glycemic control.Methods: This systematic review was conducted by searching five electronic databases, such as Scopus, PubMed, Science Direct, Springer Link and ProQuest over five years or more with full text in the English language. The search keywords were adjusted according to the medical subject headings and Boolean operators. This study used the PRISMA flow chart to select articles. Fifteen studies were included if they reported on diabetes self-care management education intervention with short message service or mobile application interventions in patients with diabetes. Reviews and editorials were excluded.Results: DSME interventions with SMS and with mobile application have effectiveness to manage and decrease glycemic control (HbA1c and blood glucose level) by health education, diet monitoring, and self-monitoring of blood glucose levels.Conclusion: This systematic review has shown that DSME intervention with SMS and mobile application significantly improves glycemic control despite the heterogeneity across the studies. The recommendation for further research is to analyze the comparison of the effectiveness of online and direct DSME intervention, which can improve glycemic control.

Development of a subset of ICNP Nursing Diagnoses for the promotion of self-care in people with diabetes mellitus: a multi-center observational study.

Self-care is a key for people with diabetes mellitus (DM) to avoid severe complications and to maintain quality of life. Person-centered and accurate nursing care plans can help nurses to deliver effective self-care promotion interventions. Few studies focused on nursing diagnoses that are specific for diabetes self-care education, and none of them used the International Classification for Nursing Practice (ICNP). International Catalogues of ICNP nursing diagnoses are missing in this field. To identify the ICNP nursing diagnoses that are useful to promote self-care in people with DM; to describe the prevalence of ICNP nursing diagnoses in self-care of people with DM. A subset of 55 ICNP nursing diagnoses was developed based on the Middle Range Theory of Self-care of Chronic Illness, and most recent diabetes clinical guidelines. Then, the subset was tested through a multicenter cross-sectional design involving a consecutive sample of 170 adults with confirmed diagnosis of Type 1 or Type 2 DM. Data were collected by medical records, physical examinations and semi-structured interviews. 1343 nursing diagnoses were identified, with an average of 8 nursing diagnoses per patient. The 100% of the nursing diagnoses were described using the pre-developed subset. Overall, the five prevalent nursing diagnoses were: Body weight problem (56.4%), Non adherence to immunization regime (53.5%), Conflicting attitude toward dietary regime (41.7%), Impaired weight monitoring (39.4%), and Lack of knowledge about blood glucose diagnostic test result (32.3%). Nursing diagnoses by self-care maintenance, monitoring and management were also described. A huge amount of nursing diagnoses was identified suggesting the need of intensive education. Clinicians and administrators can use this subset to improve the accuracy of the documentation of diabetes care. In Public Health, the subset can be used to assess the cost-effectiveness of diabetes healthcare services. Future research is needed to assess the effectiveness of this subset in settings that are different from the one where it was developed. Finally, this subset could be a starting point to develop and International ICNP Catalogue for diabetes care.

Kaizen: Interactive Gaming for Diabetes Patient Education.

Objective: An estimated 100 million Americans have diabetes, undiagnosed diabetes, a high risk of being diagnosed with diabetes, or prediabetes. Many complications can arise if diabetes is poorly managed. Hence, the need for adequate knowledge, skills, and ability to care for oneself, known as diabetes self-care management, is needed to reduce complication rates. We used an interactive platform that incorporates principles of gamification to enhance user engagement to enhance diabetes knowledge. The purpose of this descriptive pilot study was to discover what adult patients with diabetes thought about this novel educational approach to diabetes education. Materials and Methods: We collected focus group data from participants at a diabetes clinic after they played an interactive diabetes trivia game, on our software platform (Kaizen Education). Transcripts were coded and common themes were identified. Results: We conducted 9 focus groups that included 33 adult (age >18) participants who had diabetes. An overarching theme of play/gaming as a form of learning was apparent, and after analyzing the coding several themes emerged, including preferences and desired environments (clinic and home) for learning, desired players (including family, significant others), and a good balance of question difficulty. Conclusions: Participants were overwhelmingly positive about gamified education and felt empowered to lead discussions with their health care providers about diabetes self-care education, in a sense "flipping" the traditional clinic patient education paradigm. These results suggested that a flipped clinic approach could be beneficial, empowering, and engaging for patients.

Effectiveness of Pre-medical Consultation Diabetes Self-care Education Programme on Glycemic Control in Type 2 Diabetes

Effectiveness of Pre-medical Consultation Diabetes Self-care Education Programme on Glycemic Control in Type 2 Diabetes

Factors influencing diabetes self-care practice among type 2 diabetes patients attending diabetic care follow up at an Ethiopian General Hospital, 2018.

Diabetes mellitus is a global public health emergency in the twenty-first century. Diabetes patients who had to adhere to good self-care recommendation can prevent the complication associated with diabetes mellitus. Self-care management of diabetes mellitus in Sub-Saharan Africa was poor including Ethiopia. The aim of this study was to assess factors influencing diabetes self-care practice among type 2 diabetes patients at Debre Tabor General Hospital, Northwest Ethiopia diabetes clinic follow up unit. An institutional based cross-sectional survey was conducted on systematically sampled 405 type 2 diabetes patients at Debre Tabor General Hospital diabetes clinic from June 02/2018 to June 30/2018. Bivariate and multivariable logistic regression was fitted to identify independent predictors of diabetes self-care practice. A p value of less than 0.05 was used to declare statistical significance. A total of 385 type 2 diabetes patients participated with a response rate of 95%, of which 243 (63.1%) study participants had good self-care practice. The mean ± SD age of the respondents and the duration of diagnosed for diabetes mellitus was 52.28 ± 12.45 and 5.09 ± 3.80years respectively. Type 2 diabetes patients who had a glucometer at home (AOR = 7.82 CI (3.24, 18.87)), getting a diabetes education (AOR = 2.65 CI (1.44, 4.89)), and having social support (AOR = 2.72 CI (1.66, 4.47)) were statistically associated with good self-care practice. Despite, the importance of diabetes self-care practice for the management of diabetes and preventing its complications, a significant number of type 2 diabetes patients had poor diabetes self-care practice. So, to enhance this poor practice of diabetes self-care, provision of diabetes self-care education and counseling on self-monitoring blood glucose should be promote by health care providers during their follow up.

Effects of Face-To-Face and Online Training on Self-Care of Middle-Aged and Elderly People with Type 2 Diabetes: A Comparative Study.

BACKGROUND:Self-care training is one of the strategies used to control diabetes. There is some ambiguity about the appropriate method for educating middle-aged and older adults about self-care.AIM:This study aimed to compare the effects of face-to-face and online training on self-care levels in middle-aged and older adults with type 2 diabetes.MATERIAL AND METHODS:In a randomised clinical trial, 84 middle-aged and older adults with type 2 diabetes who had been referred to the Diabetes Clinic of Esfarayen in Iran, were evaluated. Patients who meet the inclusion criteria were randomly assigned into two groups. Diabetes self-care education (DSCE) was provided using a face-to-face training method in one group and using online training method in the other group. The summary of diabetes self-care activities (SDSCA) questionnaire was completed at baseline and 1 month after training.RESULTS:The mean and standard deviation of self-care scores before and 1 month after training were 43.16 ± 14.94 and 65.76 ± 10.65 in the face-to-face training group, and 37 ± 10.75 and 56.82 ± 12.06 in the online training group, respectively. The differences in the self-care scores were significant both before and after the intervention in the two groups (p < 0.05). Although the difference was greater in the face-to-face training group than in the online training group, it was not statistically significant (P > 0.05).CONCLUSION:Both face-to-face and online training had a similar effect on the self-care levels in middle-aged and older adults with type 2 diabetes. Therefore, both training methods could be used as effective techniques to meet the needs and educational requirements of middle-aged and older adults with type 2 diabetes.

Diabetes related distress in adults with type 2 diabetes mellitus: a community-based study

Background: Living with diabetes can be difficult, since it can affect the patient physically as well as psychologically. Patients with diabetes face psychological issues which may be part of the spectrum of disease experience, distinct from depression, which hinder glycaemic control. The objective of the study was to determine the prevalence of diabetes related distress, and its association with socio-demographic characteristics, in adults with type 2 diabetes.Methods: A community based cross sectional study was conducted among 250 individuals of 30-60 years, with type 2 diabetes.Results: The prevalence of diabetes related distress in the study population was 13.3%; among the sub scales highest reported was regimen related distress 21.6%, followed by physician related 17.2%, emotional burden 16.4%, and inter personal distress 14.8%. Diabetes related distress was found to have significant statistical association with occupational class. In occupational class, distress was higher among unemployed while least in unskilled workers. It was higher among older (above 50 years) participants, males, members of joint family, unmarried and those with more years of education though there was no significant difference.Conclusions: The prevalence of diabetes related distress (13.2%) especially regimen and physician related, underscores need for better clinician involvement paying appropriate attention to systematic diabetes self-care and management education, and timely diagnosis of distress for positive clinical outcome.