Motivational interviewing delivered by diabetes educators: does it improve blood glucose control among poorly controlled type 2 diabetes patients?

Diabetes Res Clin Pract. 2011 Jan;91(1):54-60. doi: 10.1016/j.diabres.2010.09.036. Epub 2010 Nov 13.

Abstract

Aim: To determine whether glycemic control is improved when motivational interviewing (MI), a patient-centered behavior change strategy, is used with diabetes self management education (DSME) as compared to DSME alone.

Methods: poorly controlled type 2 diabetes (T2DM) patients (n=234) were randomized into 4 groups: MI+DSME or DSME alone, with or without use of a computerized summary of patient self management barriers. We compared HbA1c changes between groups at 6 months and investigated mediators of HbA1c change.

Results: study patients attended the majority of the four intervention visits (mean 3.4), but drop-out rate was high at follow-up research visits (35%). Multiple regression showed that groups receiving MI had a mean change in HbA1c that was significantly lower (less improved) than those not receiving MI (t=2.10; p=0.037). Mediators of HbA1c change for the total group were diabetes self-care behaviors and diabetes distress; no between-group differences were found.

Conclusions: DSME improved blood glucose control, underlining its benefit for T2DM management. However, MI+DSME was less effective than DSME alone. Overall, weak support was found for the clinical utility of MI in the management of T2DM delivered by diabetes educators.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Allied Health Personnel* / education
  • Anxiety / etiology
  • Anxiety / physiopathology
  • Behavior Therapy
  • Computer-Assisted Instruction
  • Cost of Illness
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Hyperglycemia / prevention & control*
  • Male
  • Middle Aged
  • Motivation*
  • Patient Compliance
  • Patient Dropouts
  • Patient Education as Topic / methods*
  • Psychiatric Status Rating Scales
  • Self Care

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human