Better Behavior With Diabetes

Diabetes patients benefit from behavioral and educational interventions

(RxWiki News) Fighting diabetes takes more than drugs. Patients must learn how to manage their diet, blood sugar, and weight on a daily basis. Educational interventions can teach patients these skills.

Behavioral and educational interventions were shown to improve blood sugar control in patients with poorly controlled diabetes.

"Learn how to manage your diabetes, ask your pharmacist or therapist."

In three different studies, researchers tested the effectiveness of behavioral and educational interventions for diabetes patients. Two of the studies found that the interventions helped patients improve their blood sugar levels, while the third study found less promising results.

One study - which was conducted by Katie Weinger, Ed.D., of the Joslin Diabetes Center in Boston, and colleagues - looked at behavioral intervention for improving blood sugar control. More specifically, they compared a structured behavioral treatment to group attention control and individual control treatments.

Out of all 222 adults with diabetes in the study, those who went through the structured behavioral treatment showed the most improvement in blood sugar.

In addition, type 2 diabetes patients had more improvement than type 1 patients.

According to the study's authors, "a structured, cognitive behavioral program is more effective than two control interventions in improving glycemia in adults with long-duration diabetes."

In a second study, researchers wanted to see how well group education improved blood sugar control. JoAnn Sperl-Hillen, M.D., of HealthPartners Research Foundation, and colleagues tested the effectiveness of three different treatments for people with type 2 diabetes.

A total of 623 adults with diabetes were split up to receive either group education, individual education, or the usual care. Usual care patients received no education and served as the control group of the study.

The researchers found that individual education led to better blood sugar control in patients with type 2 diabetes. On average, those in the individual education groups reduced their HbA1c levels (a measure of blood sugar over a three-month period) by 51 percent, compared to 27 percent among group education patients and 24 percent among usual care patients.

Patients who received individual education also were more likely than others to get their HbA1c levels at or below 7 percent, a recommended target.

In the third study, Dominick L. Frosch, Ph.D., from the Palo Alto Medical Foundation Research Institute, and colleagues looked at the effectiveness of diabetes management programs for poor and socially disadvantaged patients. A total of 201 patients with poorly controlled diabetes were split into two groups: the treatment group and the control group.

Patients in the treatment group received a video behavior support intervention with a workbook and five coaching sessions with a diabetes nurse over the phone. The control group received a brochure by the National Diabetes Education Program.

Dr. Frosch and colleagues did not find many differences between the two groups. Patients in both groups, on average, had significant reductions in their HbA1c levels. There also was not a large difference between the two groups with regards to blood lipid levels (cholesterol) and blood pressure.

All three of these randomized controlled trials are published online in the Archives of Internal Medicine.

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Review Date: 
October 11, 2011