title: Sustaining short-term improvements over the long-term: results from a 2-year diabetes self-management support (DSMS) intervention.
abstract: OBJECTIVE
  This study examined the long-term impact of a 24-month, empowerment-based diabetes self-management support (DSMS) intervention on sustaining health-gains achieved from previous diabetes self-management education (DSME).
  
  
  METHODS
  Prior to the intervention, all participants received 6 months of mailed DSME consisting of weekly educational newsletters coupled with clinical feedback. The intervention consisted of 88 weekly group-based sessions that participants were encouraged to attend as frequently as they needed. Sessions were guided by participants' self-management questions and also emphasized experiential learning, coping, goal-setting, and problem-solving. Baseline, 6-month, and 30-month assessments measured A1C, weight, body mass index (BMI), blood pressure, lipids, self-care behaviors, and QOL.
  
  
  RESULTS
  This report is based on 60 African-American adults with type 2 diabetes (n=89 recruited at baseline) who completed the study. Post 6-month DSME, participants demonstrated significant improvements for diastolic BP (p<0.05), serum cholesterol (p<0.001), healthy diet (p<0.01), blood glucose monitoring (p<0.05) and foot exams (p<0.01). Post 24-month intervention, participants sustained the improvements achieved from the 6-month DSME and reported additional improvements for healthy diet (p<0.05), carbohydrate spacing (p<0.01), insulin use (p<0.05), and quality of life (p<0.05).
  
  
  CONCLUSIONS
  Findings suggest that an empowerment-based DSMS model can sustain or improve diabetes-related health gains achieved from previous short-term DSME.
authors.affiliation: University of Michigan, Department of Medical Education, University of Michigan Medical School, and Michigan Diabetes Research and Training Center, United States. tangts@umich.edu
authors.forename: Tricia S
authors.initials: TS
authors.lastname: Tang
authors.forename: Martha M
authors.initials: MM
authors.lastname: Funnell
authors.forename: Salma
authors.initials: S
authors.lastname: Noorulla
authors.forename: Mary
authors.initials: M
authors.lastname: Oh
authors.forename: Morton B
authors.initials: MB
authors.lastname: Brown
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring; D001835:Body Weight; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D004032:Diet; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011209:Power, Psychological; D011340:Problem Solving; D011788:Quality of Life; D012648:Self Care / Q000379:methods* / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D002784:Cholesterol