Effect of Self-regulation Training on Management of Type 2 Diabetes

Treatment adherence and associated factors in older people with type 2 diabetes: A qualitative study

PATIENT CONTRIBUTION

Older people with T2D participated in this study to achieve the objective of the study.

AIM

Treatment adherence is an important indicator for evaluating successful diabetes control and overall disease management. It is necessary to identify the hidden themes of the concept of treatment adherence and related factors based on the experiences of older people with T2D. Therefore, the present study was conducted to identify the concept of treatment adherence and its associated factors in older people with type 2 diabetes (T2D).

DESIGN

The study was conducted as a qualitative study using a content analysis approach.

METHODS

Semi-structured interviews were conducted with 20 older people with T2D, between May and September 2021. Data were organized using MAXQDA-10 software and analysed using the Elo and Kyngas qualitative content analysis method. We followed the COREQ Checklist to ensure rigour in our study.

RESULTS

Three themes emerged from the analysis of the data, including: 'Health literacy', 'Support umbrella' and 'responsibility'.

Determination of the Perception Level of Life Style Innovations in Type 2 Diabetes Mellitus

Background

In this tudy, our aim was to measure information and behaviors of our patients about their diseases, and to determine the level of compliance with their treatment and to investigate the causes of nonconformities.

Methods

A total of 111 patients who applied to outpatient clinics between May–December 2017 were included in this prospective cross-sectional study. Sociodemographic, clinical data, diabetes, medical nutrition therapy and physical activity questionnaires were administered face to face by the researchers.

Results

About 68.5% of the 111 patients were females. While 64.9% were primary school graduates, 58.6% were housewives and 82.9% were low income level. Body Mass Index (BMI) was found to be significantly higher in women (p=0.041). It has been found that the awareness of the patients about themselves and their illnesses are 37.8% for HbA1c, 64.8% for fasting blood sugar level, 78.3% for their height and body weight. While males had a higher score than females in the diabetes survey, females scored higher than males in the medical nutrition therapy and physical activity questionnaires. On the other hand, 46.8% of patients showed additional health problems as a cause of non-compliance to physical activity.

Conclusions

Level of knowledge and compliance with treatment were also found to be inadequate.

Behavioral interventions to improve self-management in Iranian adults with type 2 diabetes: a systematic review and meta-analysis

PURPOSE

The aim of this study was to systematically-review published experimental studies to determine the effectiveness of behavioral interventions on self-management in Iranian adults with type 2 diabetes.

METHOD

Pub Med, Web of Science, Science Direct, Ovid Medline, EBSCO, ProQuest, Google Scholar, and the Scientific Information Database (SID) were searched for English and Persian language studies published between 2009 and 2017. The primary outcome of this review was to assess the effects of behavioral interventions on glycosylated hemoglobin. Changes in the blood pressure, Lipid profiles, BMI, Self-efficacy, knowledge, attitude, practice, Self-care behaviors, social support, anxiety, and depression were the secondary outcomes.

RESULTS

Comprehensive search procedures resulted in twenty-three experimental studies with 2208 participants. Eleven studies were included in the Meta-analysis. Compared with the control group, behavioral interventions significantly lower glycosylated hemoglobin -0.61% (95% CI -0.80, -0.41). To explore the effects of the study intervention (regarding what aspects of the intervention are most effective), we then conducted a stratified analysis for HbA1c. Larger effects were found in interventions with a longer duration and higher intensity, delivered in the group format, interventions offered to individuals with higher baseline HbA1c, and interventions delivered by a multidisciplinary team. Moreover, behavioral interventions were effective in improving blood glucose, lipid profiles, knowledge, attitude, practice, self-efficacy, quality of life, and self-care.

CONCLUSION

In line with other behavioral studies, our study shows that behavioral interventions improve self-management in Iranian adults with type 2 diabetes.

Contribution of Structured Self-Monitoring of Blood Glucose to the Glycemic Control and the Quality of Life in Both Insulin- and Noninsulin-Treated Patients with Poorly Controlled Diabetes

BACKGROUND

The rate of glycemic control among diabetes patients in China is currently low. The current study aims at determining the effect of structured self-monitoring of blood glucose (SMBG) on blood glucose control as well as quality of life (QoL) in Chinese diabetes patients.

METHODS

In a 24-week, single-center, randomized, open-label, prospective trial, patients with glycated hemoglobin A_1c (HbA_1c) >8.0% were randomized to an intervention group for structured SMBG (n = 121) or a control group (n = 129). Patient data were analyzed separately according to treatment with or without insulin. At 0, 3rd, and 6th months, life satisfaction was assessed using the Chinese Normal Audit of Diabetes-Dependent Quality of Life (CN-ADDQoL) questionnaire.

RESULTS

The mean HbA_1c decrease from baseline to the study end was significant for both groups with insulin treatment (intervention group: -1.79% ± 1.97%, P < 0.001; control group: -1.05% ± 1.87%, P < 0.001) or without insulin treatment (intervention group: -1.91% ± 1.90%, P < 0.001; control group: -1.35% ± 1.82%, P < 0.001). Moreover, the insulin-treated patients in the intervention group showed a significantly more robust HbA_1c decrease than those in the control group (P = 0.007). Both therapeutic subgroups in the intervention group had a significantly higher frequency of SMBG than those in the control group (P < 0.001), but no strict deterioration of the QoL was detected. In addition, a significant HbA_1c reduction after 6 months of SMBG was seen for both insulin-treated patients (P = 0.027) and noninsulin-treated patients (P = 0.006) younger than 66 years.

CONCLUSIONS

Featured with no strict deterioration of QoL, structured SMBG was proven to be effective on the glycemic control in patients with insulin treatment, as well as in young and middle-aged patients without insulin treatment.