Posted Aug 29 , 2017 02:37 AM

Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control

Chrvala CA, et al. Patient Education and Counseling 2016;99:926

What were the findings (excerpted from the Abstract)?

The objective of this study was to assess the effect of diabetes self-management education and support methods, providers, duration, and contact time on glycemic control in adults with type 2 diabetes. The authors searched MEDLINE, CINAHL, EMBASE, ERIC, and PsycINFO to December 2013 for interventions that included elements to improve participants’ knowledge, skills, and ability to perform self-management activities as well as informed decision-making around goal setting.
From the initial search, 118 unique interventions were found with 61.9% reporting significant changes in A1C. Overall mean reduction in A1C was 0.74% and 0.17% for intervention and control groups; an average absolute reduction in A1C of 0.57%. A combination of group and individual engagement results in the largest decreases in A1C (0.88%). Contact hours >10 were associated with a greater proportion of interventions with significant reduction in A1C (70.3%). In patients with persistently elevated glycemic values (A1C > 9%), a greater proportion of studies reported statistically significant reduction in A1C (83.9%). This systematic review found robust data demonstrating that engagement in diabetes self-management education results in a statistically significant decrease in A1C levels. The data suggests mode of delivery, hours of engagement, and baseline A1C can affect the likelihood of achieving statistically significant and clinically meaningful improvement in A1C.

Why is this important?

As recently as 2014 a review of diabetes education in the US suggested that less than 7% of people with diabetes receive diabetes education (Li R, et al. Mortality and Morbidity Weekly Report 2014 63(46);1045-1049). Since their initial introduction over a decade ago, the National Standards for Diabetes Education have been the basis for educational programs including recognition programs from the American Diabetes Association and the American Association of Diabetes Educators. This study is a great summary of the effectiveness of Diabetes Education. Other studies suggest we are still not implementing such education at nearly the rate needed as the diabetes epidemic increases in the US. We should all renew our efforts to get diabetes education to the largest number of people with diabetes that we can.

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