scholarly journals Socio-Ecological Approach to Self-Management of Type 2 Diabetes: Physical Activity and Dietary Intervention

10.5772/56512 ◽  
2013 ◽  
Author(s):  
Rashid M. ◽  
John B. ◽  
Colette J.
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Dietary Intervention ◽  
Self Management ◽  
Ecological Approach

scholarly journals Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stijn Crutzen ◽  
Tessa van den Born-Bondt ◽  
Petra Denig ◽  
Katja Taxis
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Food Intake ◽  
Mixed Methods Study ◽  
Self Management ◽  
Hypoglycaemic Event ◽  
Glucose Levels ◽  
Management Issues

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.

scholarly journals Nurse Coaching and Mobile Health Compared With Usual Care to Improve Diabetes Self-Efficacy for Persons With Type 2 Diabetes: Randomized Controlled Trial

10.2196/16665 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e16665 ◽  
Author(s):  
Heather M Young ◽  
Sheridan Miyamoto ◽  
Madan Dharmar ◽  
Yajarayma Tang-Feldman
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Usual Care ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Randomized Controlled ◽  
Mhealth Technology

Background Type 2 diabetes is a growing public health problem amenable to prevention and health promotion. As healthy behaviors have an impact on disease outcomes, approaches to support and sustain diabetes self-management are vital. Objective This study aimed to evaluate the effectiveness of a nurse coaching program using motivational interviewing paired with mobile health (mHealth) technology on diabetes self-efficacy and self-management for persons with type 2 diabetes. Methods This randomized controlled trial compared usual care with an intervention that entailed nurse health coaching and mHealth technology to track patient-generated health data and integrate these data into an electronic health record. The inclusion criteria were as follows: (1) enrolled at 1 of 3 primary care clinics, (2) aged 18 years or above, (3) living with type 2 diabetes, and (4) English-speaking. We collected outcome measures at baseline, 3 months, and 9 months. The primary outcome was diabetes self-efficacy; secondary outcomes were depressive symptoms, perceived stress, physical functioning, and emotional distress and anxiety. Linear regression mixed modeling estimated the population trends and individual differences in change. Results We enrolled 319 participants; 287 participants completed the study (155 control and 132 intervention). The participants in the intervention group had significant improvements in diabetes self-efficacy (Diabetes Empowerment Scale, 0.34; 95% CI –0.15,0.53; P<.01) and a decrease in depressive symptoms compared with usual care at 3 months (Patient Health Questionnaire-9; 0.89; 95% CI 0.01-1.77; P=.05), with no differences in the other outcomes. The differences in self-efficacy and depression scores between the 2 arms at 9 months were not sustained. The participants in the intervention group demonstrated a significant increase in physical activity (from 23,770 steps per week to 39,167 steps per week at 3 months and 32,601 per week at 9 months). Conclusions We demonstrated the short-term effectiveness of this intervention; however, by 9 months, although physical activity remained above the baseline, the improvements in self-efficacy were not sustained. Further research should evaluate the minimum dose of coaching required to continue progress after active intervention and the potential of technology to provide effective ongoing automated reinforcement for behavior change. Trial Registration ClinicalTrials.gov NCT02672176; https://clinicaltrials.gov/ct2/show/NCT02672176

scholarly journals I’m sleeping my day away. Improving diabetes self-management using CPAP treatment in patients with obstructive sleep apnea and type 2 diabetes: A qualitative explorative study (Preprint)

2021 ◽  
Author(s):  
Ditte Hjorth Laursen ◽  
Gitte Rom ◽  
Anne Margareta Banghoej ◽  
Lise Tarnow ◽  
Lone Schou
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Daily Life ◽  
Self Management ◽  
Cpap Treatment ◽  
Obstructive Sleep

BACKGROUND There is a high prevalence of unexplained and unexplored obstructive sleep apnea (OSA) in patients with type 2 diabetes. Daytime symptoms of OSA include severe fatigue, cognitive problems, decreased quality of life, and reduced motivation to provide self-care, which impairs the management of both diabetes and daily life. OSA may thereby cause negative implications for diabetes self-management. Treatment for OSA is offered through Continuous Positive Airway Pressure (CPAP) which has the potential to improve sleep quality, insulin resistance and glycemic control. Although the benefits of using CPAP as treatment for OSA are clear, noncompliance is high and there is poor evidence on the perceived effect of CPAP treatment in this group of patients. OBJECTIVE The purpose of this study is to explore the impact of comorbid diabetes and OSA on daily life among older adults, and to investigate the perceived effect of CPAP treatment for OSA on patients’ diabetes self-management. METHODS A qualitative follow-up study, with in-depth semi-structured dyad interviews with couples before and after an intervention with CPAP treatment (N=22). Patients were recruited from Hilleroed Hospital in Denmark and were all diagnosed with type 2 diabetes, age > 18 years and apnea-hypopnea index (AHI) ≥ 15. All interviews were coded and analyzed using thematic analysis. RESULTS Patients and partners do not consider OSA a serious disorder as they consider OSA symptoms similar to the process of aging. Patients experience poor nocturnal sleep, frequent daytime naps, reduced cognitive function, low levels of physical activity, and a high-calorie diet, that all negatively influence their diabetes self-management. Despite the immediate benefit of the CPAP treatment, most patients have technical challenges when using the CPAP. Only patients with severe OSA symptoms inflicting their daily life overcome the challenges of CPAP and thereby improve their diabetes self-management. Patients with less life inflicting symptoms rate the CPAP challenges as more burdensome than their symptoms. CONCLUSIONS If used correctly CPAP has the potential to improve OSA resulting in better sleep quality, improved physical activity, improved diet and a better diabetes self-management. But there are many barriers in CPAP treatment and only few patients manage to overcome the barriers and comply to correct treatment. CLINICALTRIAL The study was approved by the Danish Data Protection Agency (J.nr. 2012-58-0004).

scholarly journals Spoken Animated Self-Management Video Messages Aimed at Improving Physical Activity in People With Type 2 Diabetes: Development and Interview Study

10.2196/15397 ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. e15397
Author(s):  
Colette van het Schip ◽  
Kei Long Cheung ◽  
Stan Vluggen ◽  
Ciska Hoving ◽  
Nicolaas C Schaper ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Behavior Change ◽  
Positive Reinforcement ◽  
Qualitative Content Analysis ◽  
Activity Level ◽  
Self Management ◽  
Behavior Change Techniques ◽  
Physically Active

Background Web-based tailored interventions are a promising approach to help people with type 2 diabetes successfully adopt regular physical activity. Spoken animation seems to be effective regardless of the characteristics of the user and may be a relevant strategy to communicate complex health information Objective The objectives of our study were to evaluate (1) pretesting communication elements and user appreciation, and (2) the applied behavior change techniques of the previously designed spoken animated video messages in a tailored self-management program for people with type 2 diabetes. Methods We conducted semistructured interviews with patients with type 2 diabetes recruited from general practices located in different socioeconomic status urban neighborhoods. Based on the pretesting key communication elements of Salazar’s model, we asked participants about the spoken animated video messages’ attractiveness, comprehensibility, acceptance, believability, involvement, and relevance and to what extent the video messages motivated them to become more physically active. We also assessed participants’ intention to use the spoken animated video messages and to recommend them to others. To evaluate participants’ appreciation of the different applied behavior change techniques, we conducted a post hoc analysis of the qualitative data using the MAXQDA program. Transcripts were coded by 2 coders using iterative qualitative content analysis methods to uncover key health communication issues. Results Of 23 patients who expressed an interest in participating, 17 met the inclusion criteria and 15 took part in the interviews. The positive appreciation of the comprehensibility, believability, and personalization was supported by participants’ statements on behavior change techniques and other communication elements. Reinforcement of and feedback on participants’ answers were positively evaluated as was the simplicity and concreteness of the spoken animated video messages. Most participants indicated reasons for not feeling motivated to increase their physical activity level, including being already sufficiently physically active and the presence of other impeding health factors. Conclusions Spoken animated video messages should be simple, short, concrete, and without the use of medical terminology. Providing positive reinforcement, feedback on participants’ answers, examples that match user characteristics, and the possibility to identify with the animation figures will enhance involvement in the health message. To connect more with patients’ needs and thereby increase the perceived relevance of and motivation to use an animated video program, we suggest offering the program soon after diabetes mellitus is diagnosed. We recommend piloting behavior change techniques to identify potential resistance.

scholarly journals Nurse Coaching and Mobile Health Compared With Usual Care to Improve Diabetes Self-Efficacy for Persons With Type 2 Diabetes: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Heather M Young ◽  
Sheridan Miyamoto ◽  
Madan Dharmar ◽  
Yajarayma Tang-Feldman
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Usual Care ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Randomized Controlled ◽  
Mhealth Technology

BACKGROUND Type 2 diabetes is a growing public health problem amenable to prevention and health promotion. As healthy behaviors have an impact on disease outcomes, approaches to support and sustain diabetes self-management are vital. OBJECTIVE This study aimed to evaluate the effectiveness of a nurse coaching program using motivational interviewing paired with mobile health (mHealth) technology on diabetes self-efficacy and self-management for persons with type 2 diabetes. METHODS This randomized controlled trial compared usual care with an intervention that entailed nurse health coaching and mHealth technology to track patient-generated health data and integrate these data into an electronic health record. The inclusion criteria were as follows: (1) enrolled at 1 of 3 primary care clinics, (2) aged 18 years or above, (3) living with type 2 diabetes, and (4) English-speaking. We collected outcome measures at baseline, 3 months, and 9 months. The primary outcome was diabetes self-efficacy; secondary outcomes were depressive symptoms, perceived stress, physical functioning, and emotional distress and anxiety. Linear regression mixed modeling estimated the population trends and individual differences in change. RESULTS We enrolled 319 participants; 287 participants completed the study (155 control and 132 intervention). The participants in the intervention group had significant improvements in diabetes self-efficacy (Diabetes Empowerment Scale, 0.34; 95% CI –0.15,0.53; <i>P</i>&lt;.01) and a decrease in depressive symptoms compared with usual care at 3 months (Patient Health Questionnaire-9; 0.89; 95% CI 0.01-1.77; <i>P</i>=.05), with no differences in the other outcomes. The differences in self-efficacy and depression scores between the 2 arms at 9 months were not sustained. The participants in the intervention group demonstrated a significant increase in physical activity (from 23,770 steps per week to 39,167 steps per week at 3 months and 32,601 per week at 9 months). CONCLUSIONS We demonstrated the short-term effectiveness of this intervention; however, by 9 months, although physical activity remained above the baseline, the improvements in self-efficacy were not sustained. Further research should evaluate the minimum dose of coaching required to continue progress after active intervention and the potential of technology to provide effective ongoing automated reinforcement for behavior change. CLINICALTRIAL ClinicalTrials.gov NCT02672176; https://clinicaltrials.gov/ct2/show/NCT02672176

scholarly journals Program Pendidikan dan Dampak Aktivitas Fisik pada Penanda Biokimia Pasien Diabetes Mellitus Tipe 2: A Systematic Review

2020 ◽  
Vol 11 (3) ◽  
pp. 237
Author(s):  
Novita Fajriyah ◽  
Ida Trisnawati ◽  
Wahyu Sukma Samudera
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Management Education ◽  
Educational Programs ◽  
Self Management ◽  
Static Stretching ◽  
Education Programs

Background: Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia with impaired carbohydrate, protein and fat metabolism associated with dyslipidemia, which is a risk factor for increased cardiovascular disease and mortality. Educational / physical education programs and activities are alternatives in the management of Type 2 Diabetes mellitus (T2DM). Objective: To evaluate the effect of a single intervention or a combination of educational programs and physical activity on glucose values and lipid profiles in T2DM patients. Methods: The database used in this systematic review was Scopus and PubMed / Medline, in English. The analyzed papers were published between 2016-2020. Total of 20 randomized controlled trials were included that focused on educational program interventions and physical activity in T2DM patients. Results: The selected article has shown that the implementation of physical activity programs (aerobic, resistance, aerobic and resistance combination, as well as Passive Static Stretching (PSS)) and educational programs obtained based on article analysis namely professional Problem Based Learning (PBL), Conversation maps ( CMs), self-management education conducted by nurses, education with video media, family-based, group-based education, community-based multimodal intervention methods, diabetes self-management education (DSME) programs, autonomy support (family and peers). improve glycemic control as well as lipid profile in T2DM patients. Conclusions: educational programs regarding the importance of changing lifestyles and physical activity programs are scientifically expressed as complementary therapy strategies in the treatment and metabolic control of T2DM. Suggestion: Education programs and physical activities independently or modified can be used as alternative non-pharmacological / complementary therapies by taking into account the level of education and medical history of DMT2 patients. Keywords: education; physical activity; biochemistry; type 2 diabetes mellitus ABSTRAK Latar belakang: Diabetes mellitus adalah kelainan metabolisme yang ditandai dengan adanya hiperglikemia kronis dengan gangguan metabolisme karbohidrat, protein dan lemak yang dikaitkan dengan dislipidemia, yang merupakan faktor risiko peningkatan penyakit kardiovaskular dan mortalitas. Program pendidikan/edukasi dan aktivitas fisik menjadi alternative dalam pilar penatalaksanaan Diabetes mellitus tipe 2 (DMT2). Tujuan: Mengevaluasi pengaruh intervensi tunggal atau gabungan program pendidikan dan aktivitas fisik pada nilai glukosa dan profil lipid pada pasien DMT2. Metode: Database yang digunakan dalam tinjauan sistematis ini adalah Scopus dan PubMed/Medline, dengan bahasa Inggris, Makalah yang dianalisis diterbitkan antara 2016 – 2020. Sebanyak 20 uji coba terkontrol secara acak dimasukkan yang berfokus pada intervensi program pendidikan dan aktivitas fisik pada pasien DMT2. Hasil: Artikel yang dipilih telah menunjukkan bahwa pelaksanaan program aktivitas fisik (aerobic, resistensi, gabungan aerobic dan resistensi, serta Passive Static Stretching (PSS)) dan program pendidikan yang diperoleh berdasarkan analisa artikel yaitu profesional Problem Based Learning (PBL), Conversation maps (CMs), edukasi manajemen diri yang dilakukan oleh perawat, pendidikan dengan media video, berbasis keluarga, berbasis edukasi kelompok, metode intervensi multimodal berbasis masyarakat, program Diabetes Self-Management Education (DSME), dukungan otonomi (keluarga dan teman sebaya). meningkatkan kontrol glikemik serta profil lipid pada pasien DMT2. Simpulan: program pendidikan mengenai pentingnya mengubah gaya hidup dan program aktivitas fisik secara ilmiah diungkapkan sebagai strategi terapi komplementer dalam pengobatan dan kontrol metabolic pada DMT2. Saran: Program pendidikan dan aktivitas fisik secara independen maupun dimodivikasi dapat dijadikan sebagai alternative terapi non-farmakologis / komplementer dengan memperhatikan tingkat pendidikan dan riwayat kesehatan pasien DMT2. Kata kunci: edukasi; aktivitas fisik; biokimia; diabetes mellitus tipe 2

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