Cluster randomised controlled trial: educational self-care intervention with older Taiwanese patients with type 2 diabetes mellitus--impact on blood glucose levels and diabetic complications.
OBJECTIVE
To investigate whether self care behaviours, medical outcomes and quality of life of Taiwanese elderly with Type 2 diabetes mellitus (DM) can be improved by delivery of an educational health care package.


BACKGROUND
DM is a major health problem in developed and developing countries, with older adults constituting about half of the diabetic population. Type 2 DM is the most rapidly increasing chronic disease in Taiwan.


METHODS
During 2005 and 2006, Taiwanese elderly with Type 2 DM (n = 500) were randomly allocated to either an intervention or control group. Data collection using validated instruments occurred at baseline and 6 months follow-up. Main outcome measures were blood glucose levels and diabetic complications.


RESULTS
At baseline, 88.4% participants in the control and 78.8% in the experimental group had a blood glucose level above normal range (p = 0.076); respective results at 6 months were 92.4% for the control group and 60.4% for the experimental group (p < 0.001). The multivariate adjusted result showed that the intervention group was 11.1 times less likely to have blood glucose levels above normal (p = 0.002) at 6 months follow-up compared to the control group. Occurrence of complications was significantly fewer in the intervention group at baseline and at 6 month follow-up compared to the control group (baseline: 42.0% versus 82.1%, p = 0.003; 6 month follow-up: 48.4% versus 87.0%; p = 0.006).


CONCLUSIONS
Although overall occurrence of complications remained unchanged, the educational health care package specifically developed for Taiwanese elderly with Type 2 DM improved blood glucose levels.
Ying-Hua
YH
Chao
Kim
K
Usher
Petra G
PG
Buettner
Colin
C
Holmes
D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D048909:Diabetes Complications / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic; D011788:Quality of Life; D015203:Reproducibility of Results; D012648:Self Care; D013624:Taiwan; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents