A Randomized controlled trial to assess the effectiveness of group-based Diabetes Self-Management Education (DSME) program on glycemic control and self-care activities among type-2 diabetics in South-East Delhi

https://doi.org/10.47203/IJCH.2022.v34i03.015

Published

2022-09-30

DOI:

https://doi.org/10.47203/IJCH.2022.v34i03.015

Keywords:

DSME, Glycemic Control, Indian Adults, RCT, Self-Care Activities, Type-2 DM

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Abstract

Introduction: India has the second-largest population of diabetes globally. The long-term complications due to poor glycemic control are concerning. Diabetes Self-Management Education (DSME) is a fundamental component in managing diabetes better. Objectives: This study was conducted to compare the effectiveness of group-based DSME in achieving glycemic control and improving self-care practices among people with type-2 diabetes as against the usual care. Methods: A non-blinded parallel-arm RCT among adults (? 30 years) diagnosed with Type-2 DM. Written informed consent was taken from each patient before enrollment. The sample size is estimated to be 85 in each arm according to the formula for equivalence design for an RCT. Randomization was done using a computer-generated random number table. The control arm received usual care, while the intervention group received group-based DSME in addition to usual care. At the end of 6 months, the change in glycemic control and self-care activity scores were compared between the two arms. Results: A total of 139 individuals (intervention =69; control =70) were analyzed. The proportion of females (62.1%) was higher than males (37.9%). There was no statistically significant difference at baseline. At end line, HbA1c showed a reduction from 9.3% to 6.9% in the intervention arm (P<0.001), which was greater than that in the control arm (p=0.017). All the self-care components showed a statistically significant improvement, except the medication score. Conclusions: Group-based DSME effectively increases self-care practices among people with diabetes, resulting in better glycemic control.

How to Cite

1.
Singh FHD, Islam F, Shaikh A, Pathak R, Kohli S, Kashyap V. A Randomized controlled trial to assess the effectiveness of group-based Diabetes Self-Management Education (DSME) program on glycemic control and self-care activities among type-2 diabetics in South-East Delhi: https://doi.org/10.47203/IJCH.2022.v34i03.015. Indian J Community Health [Internet]. 2022 Sep. 30 [cited 2022 Sep. 30];34(3):402-7. Available from: https://iapsmupuk.org/journal/index.php/IJCH/article/view/2286

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References

International Diabetes Federation. IDF Diabetes Atlas 10th Edition 2021. [Internet]. [Accessed on 15/09/2022]. Available from: https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf

International Diabetes Federation. IDF Diabetes Atlas 9th edition 2019. [Internet]. [Accessed on 15/09/2022]. Available from: https://diabetesatlas.org/en/

Tandon N, Anjana RM, Mohan V, Kaur T, Afshin A, Ong K, et al. The increasing burden of diabetes and variations among the states of India: the Global Burden of Disease Study 1990–2016. The Lancet Global Health. 2018;6(12):e1352–62.

Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, et al. National Standards for Diabetes Self-Management Education. Diabetes Care. 2011;34(Supplement 1):S89–96.

Steinsbekk A, Rygg L, Lisulo M, Rise MB, Fretheim A. Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis. BMC Health Services Research. 2012;12(1):213.

Deakin TA, Cade JE, Williams R, Greenwood DC. Structured patient education: the diabetes X-PERT Programme makes a difference. Diabet Med. 2006;23(9):944–54.

Wichit N, Mnatzaganian G, Courtney M, Schulz P, Johnson M. Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with Type 2 diabetes. Diabetes Res Clin Pract. 2017;123:37–48.

Rosal MC, Ockene IS, Restrepo A, White MJ, Borg A, Olendzki B, et al. Randomized Trial of a Literacy-Sensitive, Culturally Tailored Diabetes Self-Management Intervention for Low-Income Latinos: Latinos en Control. Diabetes Care. 2011;34(4):838–44.

Zhong B. How to Calculate Sample Size in Randomized Controlled Trial? J Thorac Dis. 2009;1(1):51–4.

Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000;23(7):943–50.

Indian Council of Medical Research. ICMR Guidelines for Management of Type- 2 Diabetes 2018. [Internet] [Accessed on 15/09/2022]. Available from https://main.icmr.nic.in/sites/default/files/guidelines/ICMR_GuidelinesType2diabetes2018_0.pdf

United Nations. 2011 High Level Meeting on the Prevention and Control of Non-communicable Diseases [Internet]. United Nations; [Accessed on 15/09/2022]. Available from: https://www.un.org/en/ga/ncdmeeting2011/

World Health Organization. Global report on diabetes [Internet]. [Accessed on 15/09/2022]. Available from: https://www.who.int/publications-detail-redirect/9789241565257

Huxley C, Sturt J, Dale J, Walker R, Caramlau I, O’Hare JP, et al. Is it possible to predict improved diabetes outcomes following diabetes self-management education: a mixed-methods longitudinal design. BMJ Open. 2015;5(11):e008781.

Brown SA, Garcia AA, Kouzekanani K, Hanis CL. Culturally Competent Diabetes Self-Management Education for Mexican Americans: The Starr County Border Health Initiative. Diabetes Care. 2002;25(2):259–68.

Sriram M, Doke P, Dasila P. Impact of Communication on Self Care Management among Individuals with Diabetes Mellitus in an Urban Community in Mumbai. Int J Health Sci Res. 2020;10(7):1-11.

Carpenter R, DiChiacchio T, Barker K. Interventions for self-management of type 2 diabetes: An integrative review. International Journal of Nursing Sciences. 2019;6(1):70–91.

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