scholarly journals Can the Onset of Type 2 Diabetes Be Delayed by a Group-Based Lifestyle Intervention in Women with Prediabetes following Gestational Diabetes Mellitus (GDM)? Findings from a Randomized Control Mixed Methods Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Angela O’Dea ◽  
Marie Tierney ◽  
Brian E. McGuire ◽  
John Newell ◽  
Liam G. Glynn ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Gestational Diabetes ◽  
Lifestyle Intervention ◽  
Intervention Group ◽  
Outcome Variable ◽  
Control Group ◽  
One Year

Objective. To evaluate a 12-week group-based lifestyle intervention programme for women with prediabetes following gestational diabetes (GDM).Design. A two-group, mixed methods randomized controlled trial in which 50 women with a history of GDM and abnormal glucose tolerance postpartum were randomly assigned to intervention (n=24) or wait control (n=26) and postintervention qualitative interviews with participants.Main Outcome Measures. Modifiable biochemical, anthropometric, behavioural, and psychosocial risk factors associated with the development of type 2 diabetes. The primary outcome variable was the change in fasting plasma glucose (FPG) from study entry to one-year follow-up.Results. At one-year follow-up, the intervention group showed significant improvements over the wait control group on stress, diet self-efficacy, and quality of life. There was no evidence of an effect of the intervention on measures of biochemistry or anthropometry; the effect on one health behaviour, diet adherence, was close to significance.Conclusions. Prevention programmes must tackle the barriers to participation faced by this population; home-based interventions should be investigated. Strategies for promoting long-term health self-management need to be developed and tested.

scholarly journals Shifting the Care of Type 2 Diabetes Mellitus from Hospital to Primary Health Care Institutions through an Educational Intervention for Health Care Professionals: An Example from Rural China

2020 ◽  
Vol 17 (6) ◽  
pp. 2076
Author(s):  
Shaofan Chen ◽  
Dongfu Qian ◽  
Bo Burström
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Health Care Professionals ◽  
Intervention Group ◽  
Control Group ◽  
Primary Health ◽  
One Year

This study assessed the impact of an educational intervention on the knowledge, attitudes, and practice regarding Type 2 Diabetes Mellitus (T2DM) of Primary Health Care (PHC) professionals, as well as on the types of T2DM care services which they were able to provide. The intervention was carried out in collaboration with county hospitals. The study was conducted from 2015 to 2016 among 241 health care professionals in 18 township health centers and 55 village clinics in three counties in Jiangsu Province, randomly divided into an intervention group and a control group. Participants in the intervention group received professional skills training sessions and team communication and were involved in regular meetings. The control group followed the routine work plan. At one-year follow up, the diabetes knowledge score, practice score, and attitudes score were significantly higher in the intervention group than in the control group. A significantly higher proportion of health care professionals in the intervention group was able to provide services compared with the control group, for all types of services, except T2DM emergency treatment. The intervention among health care professionals in PHC had a positive impact on their professional diabetes skills, knowledge, attitudes, practices, and types of services they were able to provide, at one-year follow-up.

scholarly journals Effectiveness of a clinic-based randomized controlled intervention for type 2 diabetes management: an innovative model of intensified diabetes management in Mainland China (C-IDM study)

2020 ◽  
Vol 8 (1) ◽  
pp. e001030 ◽  
Author(s):  
Qinglin Lou ◽  
Qing Ye ◽  
Haidi Wu ◽  
Zhiyong Wang ◽  
Robert S Ware ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Large Scale ◽  
Diabetes Management ◽  
Controlled Trial ◽  
Intervention Group ◽  
Mainland China ◽  
Outcome Variable ◽  
Control Group ◽  
Randomized Controlled

ObjectivesHighly efficient diabetes management programs are needed for tackling diabetes in China. This study aimed to assess the effectiveness of a clinic-based intensified diabetes management model (C-IDM) in Mainland China.Research design and methodsA 2-year clinic-based randomized controlled trial was conducted among patients with type 2 diabetes in Nanjing, China. The C-IDM intervention components comprised four domains (disease targeting management, express referral channel, expert visit, patients’ self-management) and an integrated running system (disease control centers, general hospitals and local clinics). Control group participants received their usual care, while intervention participants received both the C-IDM package and the usual services. The primary outcome variable was change of hemoglobin A1c (HbA1c). Mixed-effects models were used to compute effect estimates and 95% CI with consideration of both individual and cluster-level confounders.ResultsOverall, 1095 of 1143 participants were assessed at study completion. The mean change in HbA1c was significantly greater in the intervention group than in the control group (mean difference (MD)=−0.57, 95% CI −0.79 to –0.36). Similar results were observed for change in body mass index (MD=−0.29, 95% CI −0.49 to –0.10). Participants in the intervention group were more likely to achieve normal HbA1c and body weight compared with their counterparts in control group after adjusting for potentially confounding variables (adjusted OR=1.94, 95% CI 1.35 to 2.81 and 1.79, 95% CI 1.13 to 2.85, respectively).ConclusionsThe C-IDM model is feasible and effective in large-scale management of patients with type 2 diabetes in China. It has public health implications for tackling the burden of diabetes in China.Trial registration numberChiCTR-IOR-15006019.

Socioeconomic position and effectiveness of lifestyle intervention in prevention of type 2 diabetes: One-year follow-up of the FIN-D2D project

2011 ◽  
Vol 39 (6) ◽  
pp. 561-570 ◽  
Author(s):  
Nina Rautio ◽  
Jari Jokelainen ◽  
Heikki Oksa ◽  
Timo Saaristo ◽  
Markku Peltonen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
Socioeconomic Position ◽  
One Year

scholarly journals A randomised controlled trial investigating the effect of an intensive lifestyle intervention v. standard care in adults with type 2 diabetes immediately after initiating insulin therapy

2008 ◽  
Vol 99 (5) ◽  
pp. 1025-1031 ◽  
Author(s):  
Rachel Barratt ◽  
Gary Frost ◽  
D. J. Millward ◽  
Helen Truby
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Insulin Therapy ◽  
Lifestyle Intervention ◽  
Standard Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Intensive Lifestyle Intervention

Obesity and type 2 diabetes are inextricably linked. It is therefore unfortunate that insulin, the ultimate treatment to improve glycaemic control in type 2 diabetes, is associated with significant weight gain. The aim of the present investigation was to ascertain whether a dietitian-led intensive lifestyle intervention could attenuate weight gain associated with commencing insulin therapy. Subjects (n 50) with type 2 diabetes, within 4 weeks of starting insulin therapy, were randomly allocated to a control or intervention group. The control group continued with standard care whilst the intervention group followed a dietitian-led intensive lifestyle intervention. Over 6 months the control group gained 4·9 (sd 3·6) kg (P < 0·001), whilst the intervention group maintained their weight ( − 0·6 (sd 5·1) kg (NS). The difference in weight change between the groups was 5·5 kg (P < 0·001). The control group had significant increases whilst the intervention group had slight decreases in: BMI (+1·7 (sd 1·3) kg/m2 (P < 0·001) v. − 0·3 (sd 2·0) kg/m2 (NS)), waist circumference (+5·3 (sd 5·0) cm (P < 0·001) v. − 0·4 (sd 5·2) cm (NS)) and percentage body fat (+1·5 (sd 2·0) % (P < 0·001) v. − 0·4 (sd 2·8) % (NS)). Differences between the groups for these parameters were significant (P < 0·01). Throughout the study, both groups experienced significant reductions in HbA1c, but only minor changes in blood lipids. The present study demonstrates that weight gain is not an inevitable consequence of starting insulin therapy, but attenuation of the weight gain requires a high level of intervention. The first 6 months to 1 year after initiating insulin therapy provides the ideal ‘window of opportunity’.

scholarly journals Combination treatment of autologous bone marrow stem cell transplantation and hyperbaric oxygen therapy for type 2 diabetes mellitus: A randomized controlled trial

2019 ◽  
Vol 28 (12) ◽  
pp. 1632-1640
Author(s):  
Esteban J. Estrada ◽  
José Luis Decima ◽  
Guillermo Bortman ◽  
Javier Roberti ◽  
Elida Beatriz Romero ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
C Peptide ◽  
Randomized Controlled ◽  
Insulin Requirements ◽  
One Year

The objective of this study was to compare standard treatment versus the combination of intrapancreatic autologous stem cell (ASC) infusion and hyperbaric oxygen treatment (HBOT) before and after ASC in the metabolic control of patients with type 2 diabetes mellitus (T2DM). This study was a prospective, randomized controlled trial. The combined intervention consisted of 10 sessions of HBOT before the intrapancreatic infusion of ASC and 10 sessions afterwards. ASCs were infused into the main arterial supply of the pancreas to maximize the presence of the stem cells where the therapeutic effect is most desired. A total of 23 patients were included (control group = 10, intervention group = 13). Age, gender, diabetes duration, number of medications taken, body weight and height, and insulin requirements were recorded at baseline and every three months. Also, body mass index, fasting plasma glucose, C-peptide, and HbA1c, C-peptide/glucose ratio (CPGR) were measured every three months for one year. HbA1c was significantly lower in the intervention group compared with control throughout follow-up. Overall, 77% of patients in the intervention group and 30% of patients in the control group demonstrated a decrease of HbA1c at 180 days (compared with baseline) of at least 1 unit. Glucose levels were significantly lower in the intervention group at all timepoints during follow-up. C-peptide levels were significantly higher in the intervention group during follow-up and at one year: 1.9 ± 1.0 ng/mL versus 0.7 ± 0.4 ng/mL in intervention versus control groups, respectively, p = 0.0021. CPGR was higher in the intervention group at all controls during follow-up. The requirement for insulin was significantly lower in the intervention group at 90, 180, 270, and 365 days. Combined therapy of intrapancreatic ASC infusion and HBOT showed increased metabolic control and reduced insulin requirements in patients with T2DM compared with standard treatment.

The effect of proprioceptive training on postural control in people with diabetes: A randomized clinical trial comparing delivery at home, under supervision, or no training

2021 ◽  
pp. 026921552198901
Author(s):  
Nathalia Cristina de Souza Borges ◽  
Ariane Hidalgo Mansano Pletsch ◽  
Mariana Barbosa Buzato ◽  
Natalia Akemi Yamada Terada ◽  
Fernanda Maria Ferreira da Cruz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Postural Control ◽  
Force Plate ◽  
Outcome Variable ◽  
Control Group ◽  
Functional Tests ◽  
Supervised Training ◽  
Proprioceptive Training ◽  
Home Training

Objective: Analyze postural control in the bipedal position as well as during gait and functional tests in patients with type 2 diabetes mellitus after supervised and unsupervised proprioceptive training. Design: A three-group randomized controlled trial. Setting: Physiotherapeutic Resources Lab, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo Subjects: Eighty patients with type 2 diabetes allocated to three groups: control, home training, and supervised training. Interventions: The supervised and home training groups performed two weekly sessions of proprioceptive exercises for 12 weeks. The control group was not submitted to any of treatment. Main measures: Bipedal balance, gait, and performance on functional tests were evaluated before and after 12 weeks using the Balance Evaluation Systems Test (BESTest) and the force plate. Results: No significant improvements were found regarding postural control, gait, or performance on the functional tests, as evidenced by the inter-group comparisons of the total BESTest score [control: 90.7 (81.5–92.6); home training: 85.2 (77.8–90.3); supervised training: 88.4 (82.6–91.4), P > 0.05] as well as the tests performed on the force plate ( P > 0.05). The clinical effect size of the proposed intervention was less than 0.2, demonstrating no effect for the main outcome variable evaluated by the “Sensory Orientation” item of the BESTest and by the mCTSIB (pressure plate). Conclusions: The proposed proprioceptive training did not lead to improvements in postural control in patients with type 2 diabetes with no clinical signs of diabetic distal polyneuropathy when analyzed using the BESTest clinical evaluation and a force plate. Trial registration: NCT01861392 (clinicaltrials.gov).

scholarly journals Effects of a psychosocial intervention at one-year follow-up in a PREDIMED-plus sample with obesity and metabolic syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Núria Mallorquí-Bagué ◽  
María Lozano-Madrid ◽  
Cristina Vintró-Alcaraz ◽  
Laura Forcano ◽  
Andrés Díaz-López ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Depressive Symptoms ◽  
Psychosocial Support ◽  
Food Addiction ◽  
Intervention Group ◽  
Control Group ◽  
Lifestyle Recommendations ◽  
One Year ◽  
Mediational Role

AbstractThis study examines if overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms, and if these variables could be modified after 1 year of a multimodal intervention (diet, physical activity, psychosocial support). 342 adults (55–75 years) with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus Cognition study were randomized to the intervention or to the control group (lifestyle recommendations). Cognitive and psychopathological assessments were performed at baseline and after 1-year follow-up. At baseline, higher impulsivity was linked to higher food addiction and depressive symptoms, but not to body mass index (BMI). Food addiction not only predicted higher BMI and depressive symptoms, but also achieved a mediational role between impulsivity and BMI/depressive symptoms. After 1 year, patients in both groups reported significant decreases in BMI, food addiction and impulsivity. BMI reduction and impulsivity improvements were higher in the intervention group. Higher BMI decrease was achieved in individuals with lower impulsivity. Higher scores in food addiction were also related to greater post-treatment impulsivity. To conclude, overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms in mid/old age individuals with MetS. Our results also highlight the modifiable nature of the studied variables and the interest of promoting multimodal interventions within this population.

scholarly journals Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care—results of the cluster-randomised controlled DEBATE trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anja Wollny ◽  
Christin Löffler ◽  
Eva Drewelow ◽  
Attila Altiner ◽  
Christian Helbig ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Decision Making ◽  
Type 2 Diabetes Mellitus ◽  
Shared Decision Making ◽  
Intervention Group ◽  
Control Group ◽  
Shared Decision ◽  
Patient Centeredness

Abstract Background We investigate whether an educational intervention of GPs increases patient-centeredness and perceived shared decision making in the treatment of patients with poorly controlled type 2 diabetes mellitus? Methods We performed a cluster-randomized controlled trial in German primary care. Patients with type 2 diabetes mellitus defined as HbA1c levels ≥ 8.0% (64 mmol/mol) at the time of recruitment (n = 833) from general practitioners (n = 108) were included. Outcome measures included subjective shared decision making (SDM-Q-9; scale from 0 to 45 (high)) and patient-centeredness (PACIC-D; scale from 1 to 5 (high)) as secondary outcomes. Data collection was performed before intervention (baseline, T0), at 6 months (T1), at 12 months (T2), at 18 months (T3), and at 24 months (T4) after baseline. Results Subjective shared decision making decreased in both groups during the course of the study (intervention group: -3.17 between T0 and T4 (95% CI: -4.66, -1.69; p < 0.0001) control group: -2.80 (95% CI: -4.30, -1.30; p = 0.0003)). There were no significant differences between the two groups (-0.37; 95% CI: -2.20, 1.45; p = 0.6847). The intervention's impact on patient-centeredness was minor. Values increased in both groups, but the increase was not statistically significant, nor was the difference between the groups. Conclusions The intervention did not increase patient perceived subjective shared decision making and patient-centeredness in the intervention group as compared to the control group. Effects in both groups might be partially attributed to the Hawthorne-effect. Future trials should focus on patient-based intervention elements to investigate effects on shared decision making and patient-centeredness. Trial registration The trial was registered on March 10th, 2011 at ISRCTN registry under the reference ISRCTN70713571.

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