National Standards for Diabetes Self-Management Education

Harvard University, Cambridge, Massachusetts, United States
Diabetes care (Impact Factor: 8.42). 01/2011; 34 Suppl 1(6):S89-96. DOI: 10.2337/dc11-S089
Source: PubMed
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Available from: Martha M Funnell
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    • "Patients have to perform a multitude of self-care tasks on a daily basis in order to control their blood glucose and associated metabolic risk factors such as weight, blood pressure, lipids and smoking [2]. Diabetes self-management education (DSME) is therefore regarded a key component of diabetes care, aimed not only to enhance the patients' medical understanding, but also improve their intrinsic motivation, self-efficacy, illness perception , behavioural skills and behaviour [2] [3] [4]. Interventions targeting diabetes self-management behaviour have shown to improve behavioural and, to a lesser extent, clinical outcomes among its participants [5] [6]. "
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    ABSTRACT: Diabetes self-management education improves behavioural and clinical outcomes in type 2 diabetes patients, however little is known about the modifying effects of well-being. This is relevant given high prevalence of depression and distress among diabetes patients. We aimed to test whether low well-being modifies the effects of the PRISMA self-management education program (Dutch DESMOND). 297 primary care type 2 diabetes patients participated in the PRISMA observational study with a pre-post measurement design. Patients were grouped in low (n=63) and normal well-being (n=234). Low well-being was defined as either low mood (WHO-5<50) and/or high diabetes-distress (PAID-5>8). Outcome measures were: diabetes self-efficacy (CIDS), illness perception (IPQ) and diabetes self-care activities (SDSCA). Improvements were found in illness perception (b=1.586, p<0.001), general diet (b=1.508, p=0.001), foot care (b=0.678, p=0.037), weekly average diet (b=1.140, p=0.001), creating action plan (b=0.405, p=0.007). Well-being interaction effects were found for general diet (p=0.009), weekly average diet (p=0.022), and creating an action plan (p=0.002). PRISMA self-management education seems as effective for people with normal well-being as for people with low well-being. Further research should examine whether addressing mood and diabetes-distress as part of self-management education could reduce attrition and maintain or improve well-being among participants. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
    Full-text · Article · Jul 2015
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    • "Between 2007 and 2009, the prevalence of adults (≥ 21 years) in Israel with diabetes ranged from 7.6% to 8.5% (Israel Center for Disease Control 2011) and the costs associated with diabetes represented 3.5% of total healthcare expenditures in 2006 (Chodick et al. 2010). Previous studies have shown that adherence to diabetes medication and self-care protocols, which are critical components in improving diabetes-related outcomes (Funnell et al. 2012), are associated with fatalistic beliefs (Walker and Smalls 2012). "
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    ABSTRACT: This study aimed to determine whether fatalistic beliefs were associated with elevated levels of glycated hemoglobin (HbA1c) and to establish the role of religiosity in this relationship. A cross-sectional survey was conducted on a sample of 183 Jewish adults with diabetes visiting a large medical center in northern Israel. Self-administered questionnaires assessed level of religiosity, fatalistic beliefs, diabetes management behaviors, and demographic/personal characteristics; laboratory tests were used to measure HbA1c. Multivariate regression indicated that fatalism was significantly associated with HbA1c (β = 0.51, p = 0.01). The association was no longer statistically significant after including self-reported religiosity in the model (β = 0.31, p = 0.13). This phenomenon is likely due to a confounding relationship between the religious/spiritual coping component of the fatalism index and self-reported religiosity (r = 0.69). The results indicate that addressing fatalistic attitudes may be a viable strategy for improving diabetes management, but call for a better understanding of the interplay between religiosity and fatalism in this context.
    Full-text · Article · May 2015 · Journal of Religion and Health
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    • "Systematic reviews of chronic diseases have demonstrated that patient education to enhance self-management skills has a major impact on improving outcomes [17] [18]. Furthermore, it has been reported providing structured education with a combined theoretical and evidence base can lead to better outcomes [17]. "

    Full-text · Article · Jan 2015 · Health
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