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
DOI:
https://doi.org/10.33192/smj.v76i2.266524Keywords:
Diabetes self-management education, certified diabetes educator, glycemic level, stage of behavior change, quality of lifeAbstract
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
How to Cite
License
Copyright (c) 2024 Siriraj Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following conditions:
Copyright Transfer
In submitting a manuscript, the authors acknowledge that the work will become the copyrighted property of Siriraj Medical Journal upon publication.
License
Articles are licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). This license allows for the sharing of the work for non-commercial purposes with proper attribution to the authors and the journal. However, it does not permit modifications or the creation of derivative works.
Sharing and Access
Authors are encouraged to share their article on their personal or institutional websites and through other non-commercial platforms. Doing so can increase readership and citations.