科研之友
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摘要
Aims/IntroductionThe purpose of the present study was to examine glycemic control in suboptimally controlled type2 diabetes provided by a structured education group using the Diabetes Conversation Map (CM) vs usual care in a university-based hospital primary care clinic. Materials and MethodsThis was a randomized, pragmatic clinical trial. Patients with type2 diabetes were randomly assigned to structured education or usual care groups. The primary outcome was the difference in the mean change of glycated hemoglobin (HbA1c) from baseline to 12months. Secondary outcomes included the percentage achieving therapeutic HbA1c goal and self-behavioral changes. ResultsA total of 245 patients were randomly assigned to two groups (CM group n=121; usual care group, n=116). The absolute reduction of HbA1c was significantly greater in the CM group at 3 and 6months (=-0.59% and =-1.13%, P<0.01), but the difference was no longer statistically significant at 9 and 12months (=-0.43% and =-0.49%), based on an intention-to-treat analysis. A per-protocol analysis showed the significant change was maintained at 12months (=-0.67%). In the intervention group, greater percentages of patients achieved their American Association of Diabetes Educators Self-Care Behaviours framework (AADE7) behavioral goals at 3months, in particular being active, problem-solving, reducing risk and health coping. ConclusionsIn type2 diabetic patients with suboptimally controlled glucose, there were greater improvements in glucose control and self-care behavioral goals in those who underwent the CM education program compared with outcomes achieved in patients receiving usual care.
- 出版日期2015-11
- 单位河北医科大学
