The Effect of Diabetes Self-management Education Provided by Certified Diabetes Educator Compared to Usual Diabetes Education on Glycemic Level and Stage of Behavior Change in Adult with Types 2 Diabetes Mellitus

Authors

  • Kanyarat Wongmuan Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Narinnad Thanaboonsutti Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Wilawan Ketpan Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Sarawoot Uprarat Siriraj Diabetes Center of Excellence, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Varisara Lapinee Siriraj Diabetes Center of Excellence, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Lukana Preechasuk Siriraj Diabetes Center of Excellence, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

DOI:

https://doi.org/10.33192/smj.v76i2.266524

Keywords:

Diabetes self-management education, certified diabetes educator, glycemic level, stage of behavior change, quality of life

Abstract

Objective: To explore the effect of diabetes self-management education and support (DSMES) provided by Siriraj certified diabetes educators (CDE) compared to usual diabetes education (DE) on glycemic level and stage of behavior change in patients with type 2 diabetes mellitus (T2D).

Materials and Methods: Patients with T2D having A1C 8-12% were recruited between 2019-2020 to receive DSMES from CDE. Patients received the usual DE from healthcare professionals in 2016 were randomly selected from their medical records.

Results: 76 patients were enrolled in each group. Mean±SD age was 59.4±11.5 years. After receiving DSMES and DE, A1C decreased dramatically at 3 months in both groups without significant difference between the groups (9.4±1.1% to 8.0±1.2% vs. 9.5±1.1% to 8.1±1.5%, respectively). However, the DEMES group can further decrease A1C to 7.8±1.2% while A1C in the usual DE group increased to 8.5±1.6% at 12 months (p=0.028). In the DSMES group, most patients can move to the next stage of behavior change and reported a better QOL (89.4±11.6 vs. 92.6±12.2, p=0.018).

Conclusion: The receipt of DSMES from CDE significantly improved the level of A1C, the stage of behavior change, and QOL. Its benefit on the glycemic level can last at least one year.

References

Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. 2022;183:109119. DOI: https://doi.org/10.1016/j.diabres.2021.109119

วิชัย เอกพลากร. รายงานการสำรวจสุขภาพประชาชนไทยโดยการตรวจร่างกาย ครั้งที่ 6 พ.ศ. 2562 - 2563.

Preechasuk L, Tengtrakulcharoen P, Karaketklang K, Rangsin R, Kunavisarut T. Achievement of metabolic goals among different health insurance schemes in Thai patients with type 2 diabetes mellitus: A nationwide study. Siriraj Med J. 2020;72(1):1-9. DOI: https://doi.org/10.33192/Smj.2020.01

Powers MA, Bardsley JK, Cypress M, Funnell MM, Harms D, Hess-Fischl A, et al. Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care. 2020;43(7):1636-49. DOI: https://doi.org/10.2337/dci20-0023

Preechasuk L, Sriussadaporn P, Likitmaskul S. The obstacles to diabetes self-management education and support from healthcare professionals' perspectives: a nationwide survey. Diabetes Metab Syndr Obes. 2019;12:717-27. DOI: https://doi.org/10.2147/DMSO.S195916

Wongwiwatthananukit S, Krittiyanunt S, Wannapinyo AJTJPS. Development and validation of an instrument to assess the general knowledge of patients with diabetes. Thai J Pharm Sci. 2004;28(1-2):17-29.

Thai_WHOQOL-BREF [Available from: https://www.who.int/tools/whoqol/whoqol-bref/docs/default-source/publishing-policies/whoqol-bref/thai-whoqol-bref.

Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38-48. DOI: https://doi.org/10.4278/0890-1171-12.1.38

Chrvala CA, Sherr D, Lipman RD. Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control. Patient Educ Couns. 2016;99(6):926-43. DOI: https://doi.org/10.1016/j.pec.2015.11.003

Mikhael EM, Hassali MA, Hussain SA. Effectiveness of Diabetes Self-Management Educational Programs For Type 2 Diabetes Mellitus Patients In Middle East Countries: A Systematic Review. Diabetes Metab Syndr Obes. 2020;13:117-38. DOI: https://doi.org/10.2147/DMSO.S232958

Arlinghaus KR, Johnston CA. Advocating for Behavior Change With Education. Am J Lifestyle Med. 2018;12(2):113-6. DOI: https://doi.org/10.1177/1559827617745479

Razaz JM, Rahmani J, Varkaneh HK, Thompson J, Clark C, Abdulazeem HM. The health effects of medical nutrition therapy by dietitians in patients with diabetes: A systematic review and meta-analysis: Nutrition therapy and diabetes. Prim Care Diabetes. 2019;13(5):399-408. DOI: https://doi.org/10.1016/j.pcd.2019.05.001

Bowen ME, Cavanaugh KL, Wolff K, Davis D, Gregory RP, Shintani A, et al. The diabetes nutrition education study randomized controlled trial: A comparative effectiveness study of approaches to nutrition in diabetes self-management education. Patient Educ Couns. 2016;99(8):1368-76. DOI: https://doi.org/10.1016/j.pec.2016.03.017

ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2023. Diabetes Care. 2023;46(Supple 1):S68-s96. DOI: https://doi.org/10.2337/dc23-S005

Lin LK, Sun Y, Heng BH, Chew DEK, Chong PN. Medication adherence and glycemic control among newly diagnosed diabetes patients. BMJ Open Diabetes Res Care. 2017;5(1):e000429. DOI: https://doi.org/10.1136/bmjdrc-2017-000429

Ziegelstein RC. Perspectives in Primary Care: Knowing the Patient as a Person in the Precision Medicine Era. Ann Fam Med. 2018;16(1):4-5. DOI: https://doi.org/10.1370/afm.2169

Leasher JL, Bourne RR, Flaxman SR, Jonas JB, Keeffe J, Naidoo N, et al. Erratum. Global Estimates on the Number of People Blind or Visually Impaired by Diabetic Retinopathy: A Meta-analysis From 1990-2010. Diabetes Care 2016;39:1643-9. Diabetes Care. 2016;39(11):2096. DOI: https://doi.org/10.2337/dc16-er11

Ezzatvar Y, García-Hermoso A. Global estimates of diabetes-related amputations incidence in 2010–2020: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2023;195:110194. DOI: https://doi.org/10.1016/j.diabres.2022.110194

Tangvarasittichai S, Mhaoprasit K. Microalbumin Detection in Diabetes Mellitus Patients. Siriraj Med J. 2003;55(5):236-42.

ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S191-S202. DOI: https://doi.org/10.2337/dc23-S011

ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S203-S15. DOI: https://doi.org/10.2337/dc23-S012

Kashim RM, Newton P, Ojo O. Diabetic Retinopathy Screening: A Systematic Review on Patients' Non-Attendance. Int J Environ Res Public Health. 2018;15(1):157. DOI: https://doi.org/10.3390/ijerph15010157

Published

01-02-2024

How to Cite

Wongmuan, K., Thanaboonsutti, N. ., Ketpan, W. ., Uprarat, S. ., Lapinee, V. ., & Preechasuk, L. . (2024). The Effect of Diabetes Self-management Education Provided by Certified Diabetes Educator Compared to Usual Diabetes Education on Glycemic Level and Stage of Behavior Change in Adult with Types 2 Diabetes Mellitus. Siriraj Medical Journal, 76(2), 61–68. https://doi.org/10.33192/smj.v76i2.266524

Issue

Section

Original Article

Categories