Self-management education for adults with type 2 diabetes - A meta-analysis of the effect on glycemic control

被引:1159
作者
Norris, SL
Lau, J
Smith, SJ
Schmid, CH
Engelgau, MM
机构
[1] Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30034 USA
[2] Tufts Univ New England Med Ctr, Ctr Clin Evidence Synth, Div Clin Care Res, Boston, MA 02111 USA
[3] Ctr Dis Control & Prevent, Epidemiol Program Off, Atlanta, GA USA
[4] Tufts Univ New England Med Ctr, Biostat Res Ctr, Div Clin Care Res, Boston, MA 02111 USA
关键词
D O I
10.2337/diacare.25.7.1159
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - To evaluate the efficacy of self-management education on GHb in adults with type 2 diabetes. RESEARCH DESIGN AND METHODS - We searched for English language trials in Medline (1980-1999), Cinahl (1982-1999), and the Educational Resources Information Center database (ERIC) (1980-1999),and we manually searched review articles, journals With highest topic relevance, and reference lists of included articles. Studies were included if the), were randomized controlled trials that were published in the English language, tested the effect of self-management education on adults with type 2 diabetes, and reported extractable data on the effect of treatment on GHb. A total of 31 studies of 463 initially identified articles met selection criteria. We Computed net change in GHb, stratified by Follow-up interval, tested for trial heterogeneity, and calculated pooled effects sizes using random effects models. We examined the effect of baseline GHb, follow-up interval, and intervention characteristics oil GHb. RESULTS - On average, the intervention decreased GHb by 0.76% (95% CI 0.34-1.18) more than the control group at immediate follow-up, by 0.26% (0.21% increase -0.73% decrease) at 1-3 months of follow-up and by 0.26%) (0.05-0.48) at greater than or equal to4 months of Follow-up. GHb decreased more with additional Contact nine between participant and educator a decrease of 1% was noted for every additional 23.6 h (13.3-105.4) of contact. CONCLUSIONS - Self-management education improves GHb levels It immediate follow-up, and increased contact time increases the effect. The benefit declines 1-3 months after the intervention ceases, however, suggesting that learned behaviors change over time. Further research is needed to develop interventions effective in maintaining long-term glycemic control.
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页码:1159 / 1171
页数:13
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