title: Optimizing diabetes control in people with Type 2 diabetes through nurse-led telecoaching.
abstract: To study the effect of a target-driven telecoaching intervention on HbA1c and other modifiable risk factors in people with Type 2 diabetes.
  
  
  
  We conducted a randomized controlled trial in patients receiving hypoglycaemic agents. The primary outcome was HbA1c level at 6 months in the entire sample and in a subgroup with HbA1c levels ≥ 53 mmol/mol (7%) at baseline. Secondary outcomes were HbA1c at 18 months; total cholesterol, LDL, HDL, triglycerides, blood pressure, BMI and proportion of people who had achieved guideline-recommended targets at 6 and 18 months.
  
  
  
  A total of 287 participants were randomized to telecoaching and 287 to usual care. The mean (sd) baseline HbA1c level was 53 (11) mmol/mol [7.0 (1.0)%] overall and 63 (10) mmol/mol [7.9 (0.9)%] in the elevated HbA1c subgroup. At 6 months, the between-group differences in favour of telecoaching were: HbA1c -2 (95% CI -4; -1) mmol/mol [-0.2 (95% CI -0.3;-0.1)%; P=0.003] overall and -4 (95% CI -7; -2) mmol/mol [-0.4 (95% CI -0.7; -0.2)%; P=0.001] in the elevated HbA1c subgroup; BMI -0.4 kg/m(2) (95% CI -0.6; -0.1; P=0.003); total cholesterol -6 mg/dl (95% CI -11; -1, P=0.012). The proportion of participants on target for the composite of HbA1c , LDL and blood pressure increased by 8.9% in the intervention group and decreased by 1.3% in the control group (P=0.011). At 18 months, the difference in HbA1c was: -2 (95% CI -3;-0) mmol/mol [-0.2 (95% CI -0.3; -0.0)%; P=0.046] overall and -4 (-7; -1) mmol/mol [-0.4 (95% CI -0.7; -0.1)%; P=0.023] in the elevated HbA1c subgroup.
  
  
  
  Nurse-led telecoaching improved glycaemic control, total cholesterol levels and BMI in people with Type 2 diabetes. Twelve months after the intervention completion, there were sustained improvements in glycaemic control.
authors.affiliation: Leuven Institute for Healthcare Policy, Leuven, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Odnoletkova
authors.affiliation: Academic Centre for General Practice, KU Leuven, Leuven, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Goderis
authors.affiliation: Department of Endocrinology, OLV Hospital Aalst, Moorselbaan, Aalst, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: Nobels
authors.affiliation: Interuniversity Institute for Biostatistics and Statistical Bioinformatics, University of Leuven and University of Hasselt, Leuven, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Fieuws
authors.affiliation: Academic Centre for General Practice, KU Leuven, Leuven, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Aertgeerts
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Annemans
authors.affiliation: Leuven Institute for Healthcare Policy, Leuven, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Ramaekers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001530:Belgium; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002784:Cholesterol / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000451:nursing* / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D012307:Risk Factors; D017216:Telemedicine; D016896:Treatment Outcome; D014280:Triglycerides / Q000378:metabolism; D055815:Young Adult
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin; D014280:Triglycerides