Impact of Web-based nurse's education on glycosylated haemoglobin in type 2 diabetic patients.
OBJECTIVE
The purpose of this study was to evaluate whether the effect of the nurse's education using short message service of cellular phone varied according to the degree of the glycosylated haemoglobin at baseline with type 2 diabetes mellitus.


BACKGROUND
Nurse's education using telemedicine has a decrease glycosylated haemoglobin level in type 2 diabetic patients.


METHODS
A control group pretest-post-test design was used to assess the effectiveness of nurse's education.


METHODS
Fifty-one subjects completed the entire study, 25 interventions and 26 controls. Intervention and control groups were then separated into two groups by baseline-glycosylated haemoglobin, a baseline-glycosylated haemoglobin >or=7.0% and a baseline-glycosylated haemoglobin <7.0%. The goal of the intervention was to keep blood glucose concentrations close to the normal range. The intervention was applied for 12 weeks, and consisted of continuous education and reinforcement of diet, exercise and medication adjustment, as well as frequent self-monitoring of blood glucose levels. Short message service intervention was performed weekly for 12 weeks. Participants were requested to input the blood glucose level, diet and exercise diary everyday in http://www.biodang.com by cellular phone or wire Internet. The researcher sends optimal recommendations to each patient using short message service of cellular phone and wire Internet. All medication adjustments were communicated to the subjects' diabetes doctors. The glycosylated haemoglobin, fasting plasma glucose and two-hour plasma glucose were measured before and after the intervention.


RESULTS
Patients with a baseline-glycosylated haemoglobin <7.0% in intervention group maintained good control, whereas those in the control group showed significant glycosylated haemoglobin aggravation after 12 weeks. There was a significant percentage change in a baseline-glycosylated haemoglobin >or=7.0% for the intervention group (p = 0.007), with a mean percentage change of -2.15%. The percentage change in the control group was, however, not significant; this time the mean percentage change was -0.22% after 12 weeks.


CONCLUSIONS
These findings indicated that for patients with a baseline-glycosylated haemoglobin <7.0% in intervention group maintained good control, whereas those in the control group showed significant glycosylated haemoglobin aggravation. There was a significant percentage change in a baseline-glycosylated haemoglobin >or=7.0% for the intervention group; however, no significant change for the control group after 12 weeks.


CONCLUSIONS
Short message service of cellular phone intervention by a nurse can maintain and reduce glycosylated haemoglobin in a baseline-glycosylated haemoglobin <7.0% and a baseline-glycosylated haemoglobin >or=7.0% groups.
Hee-Sung
Kim
K
College of Nursing, The Catholic University, Seoul, South Korea. hees@catholic.ac.kr
D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D040421:Cell Phone / Q000706:statistics & numerical data; D003194:Computer-Assisted Instruction; D003625:Data Collection; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D003927:Diet, Diabetic; D015444:Exercise; D005215:Fasting; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism; D006801:Humans; D020407:Internet / Q000458:organization & administration*; D007723:Korea; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D010353:Patient Education as Topic / Q000458:organization & administration*; D019518:Postprandial Period; D015397:Program Evaluation
D001786:Blood Glucose; D006442:Glycated Hemoglobin