[Pilot study of two different strategies to reinforce self care behaviors and treatment compliance among type 2 diabetes patients from low income strata].
Long term diabetes self-management behaviors, and strict glycemic control are difficult to achieve in clinical practice.


OBJECTIVE
Asesss two different reinforcement strategies for diabetes selfcare management, psychological distress and glycemic control in a one year follow up study.


METHODS
70 consecutive type 2 diabetic patients, were recruited and randomly assigned to three study groups. Subjects in the control group (CG) continued with their normal treatment schedule. The second group received a reinforcement course at 6 months (RCG) and in the third group, patients were contacted monthly by phone (PHCG) to promote self-management attitudes and address problems as they arose. A battery of questions and laboratory work-up were obtained at baseline and at one year follow-up.


RESULTS
At one year follow-up, the three groups significantly increased their diabetes-related knowledge. Both experimental groups displayed improved treatment compliance and had better adherence to the recommended meal plan (p=0.06 and 0.003). In addition, the PHCG significantly increased (p<0.0001) their adherence to pharmacological treatment. No significant differences were observed in glycemic control, prevalence of depression or diabetes related distress.


CONCLUSIONS
Follow-up patient reinforcement strategies improve strategic diabetes self-care management behaviors. Further studies are needed to demonstrate the positive impact of these benefits on diabetes related outcomes.
Lerman
Israel
I
Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México D.F., México. israellerman@gmail.com
López-Ponce
Alfredo
A
Villa
Antonio R
AR
Escobedo
Michelle
M
Caballero
Enrique A
EA
Velasco
María Luisa
ML
Gómez-Pérez
Francisco Javier
FJ
Rull-Rodrigo
Juan Antonio
JA
D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011203:Poverty; D011446:Prospective Studies; D012648:Self Care