Translational research for Diabetes Self-Management in Sri Lanka: A randomized controlled trial

Prim Care Diabetes. 2015 Oct;9(5):338-45. doi: 10.1016/j.pcd.2015.01.014. Epub 2015 Feb 26.

Abstract

Aims: The study tested the hypothesis that a theory driven Diabetes Self-Management (DSM) intervention delivered by trained nurses would result in a clinically significant improvement in glycaemic control.

Methods: Patients with an HbA1c >7.5% (58mmol/mol) and free of diabetes complications were enrolled into a randomized controlled trial (n=85). Intervention consisted of four sessions and monthly follow up for 6 months. Biochemical tests, and diet and physical activity assessments were done in both groups. Analysis of covariance was used to test the effectiveness of the intervention.

Results: At 6 months, there was a significant difference (P=0.001) in HbA1c between the groups controlling for baseline values and other variables. Based on the primary outcome, 28% in the intervention group achieved the target value of 6.5% HbA1c, compared to 8% in the "usual care" group (P<0.001; η(2)=0.65). The reduction in total energy intake and increase in physical activity was significant in the intervention group between baseline and follow up.

Conclusions: The DSM intervention has resulted in a clinically significant impact on glycaemia, change in diet and physical activity, and has demonstrated the feasibility of using it within existing care arrangements in a developing country setting.

Keywords: Diabetes self-management; Randomized controlled trial; Sri Lanka.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / nursing
  • Diabetes Mellitus, Type 2 / therapy*
  • Diet
  • Energy Intake
  • Female
  • Glycated Hemoglobin / metabolism
  • Health Behavior
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Motor Activity
  • Nurse's Role
  • Patient Education as Topic
  • Self Care*
  • Sri Lanka
  • Time Factors
  • Translational Research, Biomedical*
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human