Lasting effects of a 2-year diabetes self-management support intervention: outcomes at 1-year follow-up

Prev Chronic Dis. 2012;9:E109. doi: 10.5888/pcd9.110313. Epub 2012 Jun 7.

Abstract

Introduction: 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).

Conclusion: 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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • African Americans / psychology*
  • African Americans / statistics & numerical data
  • Aged
  • Blood Glucose Self-Monitoring
  • Cholesterol / blood
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / prevention & control
  • Diabetes Mellitus, Type 2 / psychology*
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice*
  • Health Promotion / methods*
  • Humans
  • Male
  • Michigan
  • Middle Aged
  • Patient Education as Topic
  • Power, Psychological
  • Problem Solving
  • Quality of Life
  • Self Care / methods*
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Cholesterol