Supporting diabetes self-management in primary care: pilot-study of a group-based programme focusing on diet and exercise.
OBJECTIVE
To develop and implement a group self-management education programme for people with type 2 diabetes at the community level in primary care. This pilot-study intended to evaluate the feasibility, acceptability and long-term effects (12-18 months) of this programme on emotional distress, HbA1c, BMI and actual behaviour.


METHODS
An empowerment-based, theory-driven education programme was evaluated in a before-after design. The programme focused on behaviour assessment, goal-setting, problem solving and tailored information. A diabetes specialist nurse conjointly with a dietician or psychologist led five 2-hour sessions and a follow-up meeting after 3 months.


RESULTS
Forty-four people participated in 5 groups. BMI decreased with 0.45 kg/m(2) (95%CI 0.01-0.89) at 12-month and with 0.53 kg/m(2) (95%CI 0.02-1.04) at 18-month follow-up. HbA1c declined from 7.4% (+/-1.3) to 6.8% (+/-0.8) (p=0.040) and the PAID-score diminished from 28 (+/-20) to 18 (+/-13) (p=0.006) at 12-month post-intervention. These changes were only partly sustained at 18-month follow-up. Actual behaviour changed modestly.


CONCLUSIONS
Introducing the group education programme in primary healthcare is worthwhile (feasibility and effectiveness). A detailed description of the intervention is offered. Further research should explore the actual education process in greater depth.
Bastiaens
Hilde
H
Department of General Practice, Interdisciplinary Healthcare and Geriatrics, University of Antwerp, 2610 Wilrijk, Belgium. hilde.bastiaens@ua.ac.be
Sunaert
Patricia
P
Wens
Johan
J
Sabbe
Bernard
B
Jenkins
Lutgarde
L
Nobels
Frank
F
Snauwaert
Boris
B
Van Royen
Paul
P
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology / Q000534:rehabilitation*; D003927:Diet, Diabetic; D015444:Exercise; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007858:Learning; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010865:Pilot Projects; D011320:Primary Health Care; D012648:Self Care; D012944:Social Support
D007004:Hypoglycemic Agents; D007328:Insulin