MONDAY, Oct. 10 (HealthDay News) -- Three new studies show that
diabetes education and behavioral interventions can help lower
blood sugar levels in people who are having trouble managing their
Each study looked at different types of educational and
behavioral interventions and found some improvement in long-term
blood sugar control. The results are published in the Oct. 10
online edition of the
Archives of Internal Medicine.
"Diabetes education is fundamental. And, the time and effort spent with patients relates nicely to better outcomes," said Dr. Joel Zonszein, director of the clinical diabetes program at Montefiore Medical Center in New York City. "In these studies, the strategy is a little bit different in each, but it shows that education works."
But, he added, it's important to tailor the education strategy
used to the patient population. What works for people with type 1
diabetes won't necessarily work well for people living with type 2
diabetes. People who already have complications from diabetes
likely need more intensive education and follow-up than would
people who have relatively well-controlled diabetes, said
One study compared an intervention that combined aspects of
cognitive behavioral strategies with standard diabetes education in
both group and individual settings. Cognitive behavioral strategies
help identify and change negative thinking that can lead to bad
For example, in diabetes education, a behavioral strategy might
be to get people to stop thinking of blood glucose levels as either
'good' or 'bad.' "We don't allow labeling. Those numbers are
information, and all information is valuable," said the study's
lead author, Katie Weinger, an investigator in behavioral research
at the Joslin Diabetes Center in Boston.
Instead of thinking you've been bad if you get a high reading,
Weinger suggests thinking about what might have contributed to that
number, what you can do to get the number down now and what you can
do differently in the future to keep that from happening again.
Her study included 222 adults who'd been struggling with their
diabetes management for years. Fifty-one percent of the study
volunteers had type 2 diabetes and 49 percent had type 1
At the start of the study, the average hemoglobin A1C (HbA1C)
was 9 percent. HbA1C, or A1C, is a long-term measure of blood sugar
levels. It measures about two to three months of average blood
sugar levels. In general, the target for people with diabetes is to
get below 7 percent.
People in the structured behavioral group had an A1C reduction
of 0.8 percent, while the A1C of those in standard group education
dropped by 0.4 percent. People in the individual standard education
group also saw a 0.4 percent reduction.
The second study compared group education, individual education
and no assigned education. The study included 623 people with type
2 diabetes from Minnesota and New Mexico. At the start of the
study, the average A1C was above 7 percent.
After the study intervention, more people in the individual
education group -- 21.2 percent -- had an A1C below 7 percent,
compared with 13.9 percent in those in group education and 12.8
percent for those with no specific education.
The final study included 201 people -- mostly black or Latino,
and most living in poverty -- having trouble with diabetes
management. The average A1C at the start of the study was 9.6
Study participants received a 24-minute video with a workbook
and five sessions of telephone coaching from a diabetes nurse, or a
20-page brochure from the U.S. National Diabetes Education Program.
The average A1C dropped by 0.5 percent, but the researchers found
no difference between the two groups.
The bottom line, said Weinger, is "for people who are struggling
with self-management, help is available from your medical team.
There are people trained and able to support and help you. Diabetes
is difficult to manage alone."
Zonszein added that education shouldn't just occur at one time.
There needs to be reinforcement of education from time to time.
Both Weinger and Zonszein said that Medicare generally approves
up to 10 hours of diabetes education, and that many insurers follow
Learn more about living with diabetes from the
American Diabetes Association.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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