Diabetes Self-Management Course Improves Health

Researchers found that when adults with type 2 diabetes followed an individually tailored self-management program, they were better able to reduce both their weight and blood pressure, and maintain these benefits over time. Dr. Bart Thoolen of Utrecht University, and colleagues followed 196 patients with recently diagnosed type 2 diabetes who were between 50 and 70 years old and who were currently receiving either usual or intensive medical diabetes management as part of the Dutch arm of an ongoing type 2 diabetes treatment study. In contrast to non-participants, patients who followed the course were successful in making and maintaining changes in their self-care and experienced significant improvements in their physical health."

Some of these patients were randomly assigned to participate in a 3-month proactive self-management course to help them tackle problem areas in their diabetes care, while others were not. The course included two (1-hour) individual sessions and four (2-hour) biweekly group sessions led by a trained nurse. The sessions hit on topics such as the importance of diet, exercise, medications, and goal setting.

Nine months after completing the self-management course, participants had a net reduction in body mass index of 0.39, while non-participants had a net increase in body mass index of 0.38, the investigators report in Diabetes Care.

Patients who got both the self-management course and intensive medical care achieved the lowest systolic blood pressure (the top number in the reading) — 128.3 millimeters mercury on average, of all the patient groups. By comparison, patients receiving only usual care had an average systolic blood pressure of 144.9 millimeters mercury.

Combined self-managed and intensive medical care was also associated with improved control of blood sugar and cholesterol, the investigators report.

Thoolen thinks a self-management course that emphasizes realistic goal-setting and planning to achieve lifestyle change can be a valuable addition to medical care for patients with diabetes.

Diabetes Care, November 2007.

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DID YOU KNOW:
An evaluation of abdominal obesity: Obesity, in particular abdominal adiposity, is associated with increased risk of cardiovascular disease and diabetes mellitus. The International Day for Evaluation of Abdominal obesity (IDEA) is a large international non-interventional cross-sectional study. It aims to evaluate abdominal adiposity as measured by a standardized protocol in 168,000 primary care patients. The study showed that the frequency of adiposity is high in all regions of the world. Abdominal adiposity was measured as waist circumference (WC) which is an inexpensive measure that can be used in primary care. It provides a clinical marker for risk of cardiovascular disease and diabetes mellitus in all regions of the world, even in patients with normal weight. Strategies to address this global problem are required to prevent an epidemic of these major causes of morbidity and mortality. 

Circulation,116 (1942-1951): Balkau B, Deanfield J, Després J, Bassand J, Fox K, Smith S Jr, Barter P, Tan C, Van Gaal L, Wittchen H, Massien C, Haffner S International Day for the Evaluation of Abdominal Obesity (IDEA): a study of waist circumference, cardiovascular disease, and diabetes mellitus in 168,000 primary care patients in 63 countries

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