Diabetes Self-management Education Support Research Articles

The Effects of Diabetes Self-Management Education on Quality of Life for Persons With Type 1 Diabetes: A Systematic Review of Randomized Controlled Trials.

It is well documented that chronic conditions, such as diabetes, impact quality of life (QoL). QoL assessment is essential when developing and evaluating diabetes self-management education support interventions. The aim of this systematic review was to evaluate the evidence and gaps in the research and the impact of diabetes self-management education (DSME) on QoL outcomes in persons with type 1 diabetes mellitus (T1DM). A systematic review of English language studies published between January 1, 2007, and March 31, 2020, was conducted using a modified Cochrane review method. Studies were included if they were randomized controlled trials (RCTs), participants had T1DM with or without caregivers, a DSME intervention alone or a component(s) of the ADCES7™ Self-Care Behaviors was described, and QoL was a primary or secondary outcome. A 3-tiered review process was utilized for selecting articles. Retained articles were assessed for risk of bias. Nineteen articles, reporting on 17 RCTs, met inclusion criteria, of which 7 studies reported QoL as the primary outcome and 10 as a secondary outcome. Seven studies detected significant impact of DMSE on QoL outcomes in either the participants or family caregivers, which varied in participant populations, selection of QoL tools (generic vs diabetes-specific), intervention type, intervention length, and type of interventionist. DSME has the potential to influence QoL outcomes in people with T1DM. Research using more standardized methods are needed to delineate impact on a broader range of factors that influence QoL for those living with T1DM across the life span and their caregivers.

Diabetes Self-Management Education Support Healthy Teaching Kitchen Cooking Classes Delivered Using a Telehealth Technology.

The purpose of the study was to evaluate the effectiveness of diabetes self-management education and support (DSMES) among veterans with diabetes using the Healthy Teaching Kitchen (HTK) by means of telehealth communication. A retrospective chart review collected data from veterans with type 2 diabetes (T2DM) that participated in the DSMES-HTK program at 2 Veterans Affairs Northeast Ohio Healthcare System facilities between February 2013 and December 2018. A factorial design was used to compare A1C data and use of clinical video telehealth from main hub to satellite site. Statistical analyses were performed using SPSS (Version 25). Repeated measures analysis of variance (RMANOVA) were performed to compare mean A1C in veterans that attended HTK at the main site versus a telehealth site. RMANOVA was also used to compare mean A1C in veterans that attended at least 1 hands-on class versus those that attended at least 1 demonstration class. A1C values of all groups improved over time and were sustained regardless of DSMES-HTK delivery method or location. Sustained improvement in A1C was observed in patients that participated in both DSMES-HTK in person and via clinical video telehealth classes conducted by hub site facilitator with RDN, CDCES credential. The use of a clinical video telehealth strategy for DSMES-HTK capitalizes on limited, highly skilled, credentialed instructional team members.

Building a Healthy Temple diabetes self-management education support program in Hispanic faith community settings: A cluster randomized controlled trial

Diabetes self-management is key to preventing diabetes complications disproportionately affecting Hispanics. Church appears a promising setting for delivering a diabetes self-management education support (DSMES) program. “Faith-placed” (FP) programing refers to health interventions implemented in the church setting; while “faith-based” (FB) signifies integrating spirituality with health interventions. The Building a Health Temple (BHT) DSMES program integrates spirituality with DSMES to improve diabetic outcomes.This cluster-randomized trial tests the effectiveness of BHT DSMES by adapting an existing DSMES program into faith-based context. A total of 360 participants will be recruited from 18 churches (~20 participants/church). Churches will be randomly assigned to either the FB or FP intervention arm. Intervention activities will be implemented over 14 consecutive weeks. Participants in the FB arm will participate in BHT DSMES including a Health Sermon, the Self-Management Resource Center (SMRC) Diabetes Self-Management Program (DSMP), and a 7-session Healthy Bible Study, delivered by two trained church lay health leaders. Participants in the FP arm will attend the same SMRC DSMP facilitated by outside health professional, followed by a 7-session community health and safety curriculum as a partial attention control intervention. The primary outcome will be a change in Hemoglobin A1c (HbA1c) level. Secondary outcomes include: changes in body mass index, waist circumference, diabetes distress score, diabetes self-care behaviors, eating behavior, and physical activity level. Data will be collected at baseline, 6, 9, and 12 months during the study period.The proposed study will lead to innovative DSMES program delivery through faith settings for Hispanic persons with diabetes.

SAT-646 Do Diabetes and Hypertension Mobile Apps Overlap?

Background: Mobile health apps have 3.7 billion downloads yearly. The interest in patient-generated data is increasing yearly. Diabetes and cardiovascular apps occupy a significant part of the eHealth space. However, diabetic patients could have both diabetes (DM) and hypertension (HTN), and hypertensive patients may have prediabetes or diabetes as well. Do these eHealth apps meet the needs of the patient with both diabetes and hypertension? Purpose: Do Diabetes apps ask questions about blood pressure control and do Hypertension apps ask questions about diabetes management? Methods: Using the search term “diabetes,” and similarly, using the search term “blood pressure” (BP), Google Play Store was accessed for two lists of the most downloaded, free DM and BP Android apps. Inclusion criteria: 1) downloads > 100,000, 2) free, 3) medication adherence (push notification), 4) FBS/HbA1c, 5) lipids. For the diabetes apps, we evaluated them for Diabetes Self-Management Education Support Guidelines (DSMES), in addition to renal and CV complications. For the BP apps, we evaluated them for BP, ACC/AHA guidelines, weight, BMI, Diet, Na+ intake, K+ intake, exercise log, alcohol intake, and medication log. Exclusion criteria: purely educational apps, no data on downloads or rankings. Results: 10 diabetes mobile apps in descending order were: 1) mySugr, 2) Onetouch Reveal, 3) Ontrack Diabetes, 4) Diabetes, 5) Health2Sync - Diabetes Care, 6) Diabetes Connect, 7) Glucose Buddy Diabetes Tracker, 8) Diabetes:M, 9) Blood Glucose Tracker, and 10) OneDrop Diabetes Management. We found 10/10 tracked FBS/HbA1c; 18.2%-81.8% had DSMES; 1/10 log entry of “heart palpitation;” 0/10 renal complications; 7/10 medication reminders. 10 blood pressure apps in descending order were: 1) BP (Szymon), 2) BP Watch, 3) BP Log My Diary, 4) BP Diary (openit.inc), 5) BP Log (bpresso.com), 6) BP Diary (FRUCT), 7) BloodPressureDB, 8) Cardio Journal, 9) BP (OrangeKit), 10) BP Diary (Health&Fitness Tracker). We found 10/10 BP logs; 2/10 ACC BP guidelines; 3/10 HbA1c/FBS; 1/10 lipid log; 0/10 diet, Na+ intake, K+ intake; 2/10 exercise log; 8/10 push notification for medication adherence. Discussion: eHealth apps emphasize the use of patient generated health data to manage chronic disease and cost containment. This small study shows that for the most popular, free diabetes and hypertension apps, few follow all the guidelines from the ADA or ACC/AHA. Conclusion: The Diabetes apps follow the DSMES guidelines more than the Hypertension apps follow the ACC/AHA guidelines. In the future, there is room for improvement for eHealth apps and the management of diabetes and comorbid conditions such as hypertension.

A Diabetes Self-Management Education/Support (DSME/S) Program in Reference to the Biological, Psychological and Social Aspects of a Patient with Type 2 Diabetes Mellitus: A Systematic Review

Introduction: Various efforts have been made to improve the self-care management of patients with type 2 diabetes mellitus (T2DM). One of them is by using a Diabetes Self-Management Education and Support (DSME/S) program. DSME/S produces positive effects in relation to patient behavior and health status. This is a systematic review of randomized controlled trials published where the aim was to evaluate the impact of the DSME/S program in term of biological. psychological and social aspects.Methods: The articles were searched for using the PRISMA approach from within Scopus, Sage Journal, ProQuest, Google Scholar and PubMed to identify the relevant English publications on DSME over the last 5 years (2013-2018). In total, 15 studies met the inclusion criteria.Results: The articles included at least one result that covered the biological, psychological, and social aspects that are more general and relevant for T2DM patients who received the DSME program. DSME had a positive impact on T2DM, namely the reduction of HbA1c, blood glucose, LDL, cholesterol, blood pressure, weight, waist circumference, decreased distress, anxiety and increased self-efficacy and self-empowerment.Conclusion: It can increase the social and family support, improve self-management motivation, increase knowledge and improve the behavior of T2DM patients. The findings of our review showed that DSME has a positive impact on the biological, psychological and social aspects of type 2 diabetes mellitus.

Decision Cycle for Patient-Centered Glycemic Management in Type 2 Diabetes

Effective glycemic control is crucial to achieving the ultimate goal of preventing complications and optimizing quality of life in patients with Type 2 diabetes. The American Diabetes Association and European Association for the Study of Diabetes recommend using the Decision Cycle for Patient-Centered Glycaemic Management as a model for caring for patients with Type 2 diabetes. This article describes the seven steps of this model. These steps are: (1) Assess key patient characteristics; (2) Consider specific factors that impact choice of treatment; (3) Shared decision-making to create a diabetes self-management education support plan; (4) Agree on a management plan; (5) Implement management plan; (6) Conduct regular monitoring and support; and (7) Review and agree on the management plan. Healthcare providers could apply these seven steps to help patients with Type 2 diabetes achieve optimal glycaemic management.