title: Motivational interviewing delivered by diabetes educators: does it improve blood glucose control among poorly controlled type 2 diabetes patients?
abstract: OBJECTIVE
  To determine whether glycemic control is improved when motivational interviewing (MI), a patient-centered behavior change strategy, is used with diabetes self management education (DSME) as compared to DSME alone.
  
  
  METHODS
  poorly controlled type 2 diabetes (T2DM) patients (n=234) were randomized into 4 groups: MI+DSME or DSME alone, with or without use of a computerized summary of patient self management barriers. We compared HbA1c changes between groups at 6 months and investigated mediators of HbA1c change.
  
  
  RESULTS
  study patients attended the majority of the four intervention visits (mean 3.4), but drop-out rate was high at follow-up research visits (35%). Multiple regression showed that groups receiving MI had a mean change in HbA1c that was significantly lower (less improved) than those not receiving MI (t=2.10; p=0.037). Mediators of HbA1c change for the total group were diabetes self-care behaviors and diabetes distress; no between-group differences were found.
  
  
  CONCLUSIONS
  DSME improved blood glucose control, underlining its benefit for T2DM management. However, MI+DSME was less effective than DSME alone. Overall, weak support was found for the clinical utility of MI in the management of T2DM delivered by diabetes educators.
authors.affiliation: Department of Behavioral Medicine Research, Baystate Medical Center, 140 High Street, Room 2104, Springfield, MA 01105, United States. Garry.Welch@baystatehealth.org
authors.forename: Garry
authors.initials: G
authors.lastname: Welch
authors.forename: Sofija E
authors.initials: SE
authors.lastname: Zagarins
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Feinberg
authors.forename: Jane L
authors.initials: JL
authors.lastname: Garb
mesh_terms: D000328:Adult; D000368:Aged; D000488:Allied Health Personnel / Q000193:education; D001007:Anxiety / Q000209:etiology / Q000503:physiopathology; D001521:Behavior Therapy; D003194:Computer-Assisted Instruction; D017281:Cost of Illness; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance; D010352:Patient Dropouts; D010353:Patient Education as Topic / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D012648:Self Care
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human