title: Experience-based group education in Type 2 diabetes: a randomised controlled trial.
abstract: Few studies have demonstrated an effect of educational interventions on glycaemic control in persons with Type 2 diabetes longer than 3-6 months after baseline. We aimed to investigate the effectiveness of an experience-based group educational programme 24 months after baseline and to pinpoint mediators that might play a role in achieving desired metabolic outcomes. We conducted a randomised controlled trial inviting self-referred persons with Type 2 diabetes (N=77 randomised). The pharmacist-led, year-long intervention was based on participants' experiences of glucose regulation during the monthly group discussions. We measured HbA1c at 0, 6, 12, and 24 months and a questionnaire was administered at baseline and final follow-up. Our findings indicated that participating in the intervention programme significantly decreased HbA1c by 0.4% at 24 months after baseline. Initial HbA1c, satisfaction with own diabetes-related knowledge, and treatment were found directly related to glycaemic outcomes. The intervention group exercised more in order to lower blood-glucose levels and was also more able to predict current blood-glucose levels before measuring it. Experience-based group education was effective in decreasing participants' HbA1c 1-year after completed intervention. Early effect of the intervention was followed by relapse after 12 months and a new, significant decrease at 24 months; this dual course implies that follow-up of educational interventions should involve several consecutive measurements to capture possible late effects. Both biomedical and subjective factors played a role in accounting for the variance of HbA1c at 2-year follow-up after baseline.
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala Science Park, Uppsala SE-751 85, Sweden. Anna.Sarkadi@pubcare.uu.se
authors.forename: Anna
authors.initials: A
authors.lastname: Sarkadi
authors.forename: Urban
authors.initials: U
authors.lastname: Rosenqvist
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001294:Attitude to Health; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000517:prevention & control* / Q000523:psychology; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009720:Nurse Clinicians / Q000458:organization & administration; D010353:Patient Education as Topic / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration; D018794:Problem-Based Learning / Q000458:organization & administration*; D015397:Program Evaluation; D012044:Regression Analysis; D012648:Self Care / Q000379:methods / Q000523:psychology; D020377:Self Efficacy; D012657:Self-Help Groups / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D013548:Sweden
chemical_list: D006442:Glycated Hemoglobin