Lasting effects of a 2-year diabetes self-management support intervention: outcomes at 1-year follow-up.
BACKGROUND
Diabetes-related health improvements achieved from self-management education interventions are not sustained long-term. We examined the health effects at 1 year follow-up of a 2-year, empowerment-based, diabetes self-management support intervention designed for African Americans.


METHODS
We collected data from 52 African American adults with type 2 diabetes who completed the 3-year study. The intervention consisted of weekly groups led by 2 health care professionals and emphasized experiential learning, emotional coping, problem solving, goal setting, and action planning; group discussion was guided by participant-identified self-management priorities and concerns. Measurements were taken at baseline, 24 months (postintervention), and 36 months (1 year follow-up) to assess glycemic control; weight; body mass index; serum cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels; systolic and diastolic blood pressure; self-care behaviors; diabetes-specific quality of life; and diabetes empowerment.


RESULTS
Following the 2-year diabetes self-management support intervention, we found significant improvements for following a healthy diet (P = .03), spacing carbohydrates evenly across the day (P = .005), using insulin as recommended (P = .047), and achieving diabetes-specific quality of life (P = .02). At 1-year follow-up, not only did participants sustain the behavioral improvements made in the 2-year diabetes self-management support intervention, but they also demonstrated additional improvements in glycemic control (P < .001) and in serum cholesterol (P < .001) and low-density lipoprotein cholesterol levels (P = .001).


CONCLUSIONS
Participation in an empowerment-based diabetes self-management support intervention may have a positive and enduring effect on self-care behaviors and on metabolic and cardiovascular health.
Department of Medicine, University of British Columbia School of Medicine, Diamond Health Care Center, Vancouver, BC. tricia.tang@vch.ca
Tricia S
TS
Tang
Matthew M
MM
Funnell
Mary
M
Oh
D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D015190:Blood Glucose Self-Monitoring; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010353:Patient Education as Topic; D011209:Power, Psychological; D011340:Problem Solving; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D002784:Cholesterol