title: A structured, group-based diabetes self-management education (DSME) programme for people, families and whanau with type 2 diabetes (T2DM) in New Zealand: an observational study.
abstract: BACKGROUND
  Group-based diabetes self-management education (DSME) programmes have been shown to be effective. A programme tailored for the unique social and ethnic environment of New Zealand (NZ) was developed using concepts from internationally developed programmes.
  
  
  OBJECTIVE
  To assess the effectiveness of a 6 week New Zealand specific DSME programme.
  
  
  METHODS
  In this observational study people with type 2 diabetes (aged 18-80 years) from diverse cultural backgrounds were recruited from primary care. Seventeen groups of six education sessions were run. Clinical data were collected from primary care at baseline, 3, 6 and 9 months. Participants also completed a self-administered questionnaire on diabetes knowledge, and self-management behaviours.
  
  
  RESULTS
  107 participants, mean age 56.7±11.3 years and mean duration of diabetes 7.5±7 years (NZ European (44%), Maori (24%), Pacific (16%) and Indian (16%)), were enrolled. Confidence in self-managing diabetes, regular examination of feet, physical activity levels and smoking rates all improved. Glycaemic control improved between baseline and 6 months (HbA1C 64.9±20.0 mmol/mol to 59.9±13.9 mmol/mol (p<0.05) (baseline 8.07%±1.80, 6 months 7.62%±1.25)), but was no different to baseline at 9 months. Systolic BP reduced from 131.9±16.4 to 127.4±18.2 mmHg (p<0.05) at 6 months, but increased to baseline levels by 9 months. Diastolic BP, triglycerides and urine microalbumin:creatinine ratio were significantly reduced at 3, 6 and 9 months.
  
  
  CONCLUSIONS
  A group-based DSME programme designed specifically for the NZ population was effective at improving aspects of diabetes care at 6 months. The attenuation of these improvements after 6 months suggests a refresher course at that time may be beneficial.
authors.affiliation: Department of Medicine, University of Otago, Wellington, PO Box 7343, Wellington, New Zealand. jeremy.krebs@ccdhb.org.nz
authors.forename: J D
authors.initials: JD
authors.lastname: Krebs
authors.forename: A
authors.initials: A
authors.lastname: Parry-Strong
authors.forename: E
authors.initials: E
authors.lastname: Gamble
authors.forename: L
authors.initials: L
authors.lastname: McBain
authors.forename: L J
authors.initials: LJ
authors.lastname: Bingham
authors.forename: E S
authors.initials: ES
authors.lastname: Dutton
authors.forename: S
authors.initials: S
authors.lastname: Tapu-Ta'ala
authors.forename: J
authors.initials: J
authors.lastname: Howells
authors.forename: H
authors.initials: H
authors.lastname: Metekingi
authors.forename: R B W
authors.initials: RB
authors.lastname: Smith
authors.forename: K J
authors.initials: KJ
authors.lastname: Coppell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D003466:Cultural Characteristics; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000208:ethnology / Q000628:therapy; D005195:Family Relations / Q000208:ethnology; D006126:Group Processes; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D008019:Life Style / Q000208:ethnology; D016014:Linear Models; D009520:New Zealand / Q000453:epidemiology; D010353:Patient Education as Topic; D012648:Self Care / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome