Thursday, November 7, 2013

A structured, group-based diabetes self-management education (DSME) programme for people, families and whanau with type 2 diabetes (T2DM) in New Zealand: An observational study

Publication date:

July 2013

SOURCE:Primary Care Diabetes, Volume 7, Issue 2

Author(s): J.D. Krebs , A. Parry-Strong , E. Gamble , L. McBain , L.J. Bingham , E.S. Dutton , S. Tapu-Ta'ala , J. Howells , H. Metekingi , R.B.W. Smith , K.J. Coppell

BackgroundGroup-based diabetes self-management education (DSME) programmes have been shown to be effective. A programme tailored for the unique social and ethnic environment of New Zealand (NZ) was developed using concepts from internationally developed programmes.AimTo assess the effectiveness of a 6 week New Zealand specific DSME programme.MethodsIn this observational study people with type 2 diabetes (aged 18-80 years) from diverse cultural backgrounds were recruited from primary care. Seventeen groups of six education sessions were run. Clinical data were collected from primary care at baseline, 3, 6 and 9 months. Participants also completed a self-administered questionnaire on diabetes knowledge, and self-management behaviours.Results107 participants, mean age 56.7 11.3 years and mean duration of diabetes 7.5 7 years (NZ European (44%), Maori (24%), Pacific (16%) and Indian (16%)), were enrolled. Confidence in self-managing diabetes, regular examination of feet, physical activity levels and smoking rates all improved. Glycaemic control improved between baseline and 6 months (HbA1C 64.9 20.0mmol/mol to 59.9 13.9mmol/mol (p 0.05) (baseline 8.07% 1.80, 6 months 7.62% 1.25)), but was no different to baseline at 9 months. Systolic BP reduced from 131.9 16.4 to 127.4 18.2mmHg (p 0.05) at 6 months, but increased to baseline levels by 9 months. Diastolic BP, triglycerides and urine microalbumin:creatinine ratio were significantly reduced at 3, 6 and 9 months.ConclusionA group-based DSME programme designed specifically for the NZ population was effective at improving aspects of diabetes care at 6 months. The attenuation of these improvements after 6 months suggests a refresher course at that time may be beneficial.
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