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AIMS: Intensive 5-day educational interventions for people with Type 1 diabetes have shown improved outcomes in a number of European studies. The aim was to assess the effectiveness of a brief (2.5 days) psycho-educational interve...
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AIMS: Intensive 5-day educational interventions for people with Type 1 diabetes have shown improved outcomes in a number of European studies. The aim was to assess the effectiveness of a brief (2.5 days) psycho-educational intervention. METHODS: Our randomized trial in a secondary-care setting had 54 and 60 participants allocated to intervention and control groups, respectively. Primary outcomes were HbA1c and severe hypoglycaemia. Secondary outcomes were blood pressure, weight, height, lipids and psychometric profile. RESULTS: HbA1c showed no statistically significant change at 3 months [difference = 0.01, 95% confidence interval (CI) -0.23, 0.26, P = 0.92], 6 months (difference = -0.06, 95% CI -0.32, 0.20, P = 0.67) and 12 months (difference = 0.01, 95% CI -0.30, 0.32, P = 0.94). Incidence of severe hypoglycaemia (per patient per year) in the intervention group (0.41) and control group (0.48) was not statistically different. Treatment satisfaction improved at 3 months (difference = 9.4, 95% CI 5.2, 13.6, P = 0.0005), 6 months (difference = 10.4, 95% CI 6.0, 14.8, P = 0.0005) and 12 months (difference = 7.1, 95% CI 2.1, 12.1, P = 0.006). The 'Managing psychological aspects' and 'Setting and achieving goals' dimensions of the Diabetes Empowerment Scale also showed significant improvement at 3, 6 and 12 months. Diabetes Knowledge Test, Illness Perception Questionnaire, Hypoglycaemia Fear Scale and Short Form 36 showed no significant change. CONCLUSIONS: This brief intervention had no significant impact on HbA(1c) or severe hypoglycaemia, but improved diabetes treatment satisfaction and patient empowerment. Current Controlled Trials ISRCTN75807800.
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There is no doubt that insulin therapy is effective in the management of people with diabetes. Indications for the use of insulin are agreed, but wide variations exist in the practice of starting people with diabetes on insulin. C...
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There is no doubt that insulin therapy is effective in the management of people with diabetes. Indications for the use of insulin are agreed, but wide variations exist in the practice of starting people with diabetes on insulin. Current health care practices in the United Kingdom are increasingly being based on scientific evidence. This literature review concentrates on current insulin initiation practice, examining the evidence base for the insulin regimens used, the process for determining starting doses and the decision making process involved. It concludes that there are wide variations in practice among the multidisciplinary team and that there is little published regarding the commencement of people with type 2 diabetes on insulin. It is likely that custom and habit still play a large role in current practice. Copyright 2006 John Wiley & Sons, Ltd.
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摘要 :
Illness can have a number of effects on diabetes, which require changes in management based on the individual patient's needs. Common effects of illness are discussed, together with strategies for regaining control. Where there is...
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Illness can have a number of effects on diabetes, which require changes in management based on the individual patient's needs. Common effects of illness are discussed, together with strategies for regaining control. Where there is any doubt about the patient's condition or the dosage change, specialist advice should be sought
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摘要 :
The need to start insulin therapy for patients with Type 2 diabetes marks a significant turning point in disease progression. It can be an anxious time for patients, who may fear the thought of insulin treatment. This paper looks ...
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The need to start insulin therapy for patients with Type 2 diabetes marks a significant turning point in disease progression. It can be an anxious time for patients, who may fear the thought of insulin treatment. This paper looks at a model of insulin initiation in primary care, with an emphasis on patient self-management.
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