| Summary: | Background Diabetes self-management is an important measure to reduce the adverse impact of the disease and improve the outcome in patients with diabetes. Existing diabetes self-management studies mainly focus on the evaluation of short-term intervention effects, but rarely report the long-term effects. Objective To evaluate the short- and long-term effects of group-based self-management activities on comprehensive glycemic control in type 2 diabetes patients in the community. Methods In 2014, 500 adults with type 2 diabetes were recruited from Fangshan District, Beijing, and randomly divided into a control group (n=241) and an intervention group (n=259). Both groups received routine diabetes follow-up services. The intervention group also received a three-month group-based self-management activities. We conducted four surveys at different times (at baseline, and three months, two years and five years post-intervention) to collect patient demographics, disease condition, comprehensive glycemic control indicators〔body mass index (BMI), blood pressure, fasting plasma glucose (FGP), glycated hemoglobin (HbA1c), high-density lipoprotein cholesterol (HDL-C), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C) 〕. Generalized estimating equations were used to analyze the main effect of the self-management activities and the interaction effect of the activities with post-intervention time. Results After adjusting for potential confounders, the main effects of the self-management activities on BMI, systolic blood pressure, diastolic blood pressure, FPG, HbA1c, HDL-C, TG an LDL-C were not statistically significant (P>0.05). The main effects of time of intervention on various indicators were statistically significant (P<0.05). Specifically, the BMI, systolic blood pressure, diastolic blood pressure, FPG, HbA1c, HDL-C and LDL-C increased, and TG decreased in the patients after intervention. We found the self-management activities and the intervention time had an interaction effect on BMI〔β (95%CI) =-0.33 (-0.62, -0.05) 〕, FPG〔β (95%CI) =-1.03 (-1.71, -0.35) 〕, and TG〔β (95%CI) =-0.54 (-0.93, -0.14) 〕: the BMI of the intervention group was 0.31 kg/m2 lower than that of the control group at baseline, and was 0.64 kg/m2 lower than that of the control group at three months post-intervention; the FPG of the intervention group was 0.19 mmol/L higher than that of the control group at baseline, but was 0.84 mmol/L lower than that of the control group at two years post-intervention; the TG of the intervention group was 0.03 mmol/L higher than that of the control group at baseline, but was 0.51 mmol/L lower than that of the control group at five years post-intervention. Conclusion Group-based self-management activities have a short-term effect on controlling BMI, and may have a long-term effect on controlling FPG and TG in patients with type 2 diabetes.
|
|---|