What is the effectiveness of a diabetes education intervention on glycemic control and self-management behaviors in patients with Type 2 Diabetes Mellitus (T2DM)?

From the Guidelines

Diabetes education focused on proper portion sizes and food label reading using American Diabetes Association materials is effective in improving glycemic control and self-management behaviors in patients with Type 2 diabetes, particularly in rural clinic settings where access to specialized dietitian services may be limited. The intervention evaluated in this quality improvement project resulted in statistically significant improvements in HbA1c levels, with mean values decreasing from 8.8% to 7.6% (p=0.025) over the 8-week period, as well as significant improvements in dietary control (p=0.023) 1. The patient population consisted primarily of Hispanic patients (19), with fewer White (7) and Black (1) participants, and was predominantly female (20 vs 7 males). Key findings include:

• Statistically significant improvements in HbA1c levels
• Significant improvements in dietary control
• Slight improvement in glucose management, though not statistically significant
• Slight decrease in physical activity scores, suggesting this area needs more targeted interventions
• Minimal change in healthcare utilization The approach aligns with the American Diabetes Association's emphasis on education that enables dietary change and supports Healthy People 2030 goals of increasing diabetes education at diagnosis 1. Overall, the results demonstrate the effectiveness of focused diabetes education in improving glycemic control and self-management behaviors, particularly in rural clinic settings. The use of verified teaching materials from the American Diabetes Association, such as the Create Your Plate method and Making Choices Using Food Labels, can be an effective strategy for educating patients with Type 2 diabetes on proper portion sizes and food label reading. Additionally, the Diabetes Self-Management Questionnaire (DSMQ) can be a reliable and valid tool for evaluating diabetes self-management behaviors in patients, as shown in the study by Schmitt et al. (2022) 1. By prioritizing diabetes education and using effective teaching materials and evaluation tools, healthcare providers can improve glycemic control and self-management behaviors in patients with Type 2 diabetes, ultimately reducing morbidity, mortality, and improving quality of life.

From the Research

Background and Significance

• The global prevalence of Type 2 diabetes (T2DM) has been rising, with over 400 million people affected in 2014, according to the World Health Organization [WHO] 2.
• The Centers for Disease Control and Prevention (CDC) reports a gradual increase in the national prevalence of diabetes over the past decade 3.
• T2DM poses a significant economic burden, costing the nation over a trillion dollars annually and affecting nearly half a billion people 4.
• The importance of diabetes self-management is highlighted by the fact that only 51.7% of adults with diabetes receive diabetes education and support from healthcare providers, as reported by Healthy People 2030 5.

Study Findings

• A study published in Clinical medicine insights. Endocrinology and diabetes found that controlling HbA1c can help reduce the symptoms and complications of diabetes, but only about 25% of adults with diabetes achieve this goal 2.
• Research published in Healthcare (Basel, Switzerland) found that enhanced self-management of diabetes is associated with improved glucose control, emphasizing the importance of maintaining optimal lifestyle changes to avoid hyperglycaemia and its complications 3.
• A study in Frontiers in clinical diabetes and healthcare presented a revised and updated version of the Diabetes Self-Management Questionnaire (DSMQ-R) and evaluated its properties in assessing self-management practices in type 1 and type 2 diabetes 4.
• The DSMQ has been found to be a reliable and valid instrument for assessing self-care activities associated with glycaemic control, with significant correlations with HbA1c levels 5, 6.

Intervention and Results

• The introduction of an educational intervention using verified teaching materials from the American Diabetes Association (ADA) resulted in statistically significant improvements in HbA1c values and dietary behavior among patients with T2DM.
• The Diabetes Self-Management Questionnaire (DSMQ) was used to evaluate diabetes self-management behaviors, with results showing improvement in glucose management, dietary control, and healthcare use, although physical activity showed a slight decline.
• The overall DSMQ scores indicated better diabetes self-management behaviors following the intervention, with a statistically significant improvement in dietary control and a slight increase in healthcare use that was not statistically significant.

Key Findings and Implications

• The study's findings support the connection between better self-management behaviors and improved glycemic control, highlighting the importance of diabetes education and support in achieving optimal diabetes outcomes.
• The use of the DSMQ as a tool for evaluating diabetes self-management behaviors is supported by the study's results, which demonstrate its reliability and validity in assessing self-care activities associated with glycaemic control.
• The study's results have implications for the development of targeted interventions to improve diabetes self-management behaviors, particularly in areas such as physical activity and healthcare use.