Optimizing Diabetes Self-Management Outcomes in Low-Income Ethnic Minority Patients in the United States

2.50
Hdl Handle:
http://hdl.handle.net/10755/616374
Category:
Full-text
Type:
Presentation
Title:
Optimizing Diabetes Self-Management Outcomes in Low-Income Ethnic Minority Patients in the United States
Other Titles:
Health Promotion in the Diabetic Patient
Author(s):
Berry, Diane C.; Williams, Wanda M.
Lead Author STTI Affiliation:
Alpha Alpha
Author Details:
Diane C. Berry, RN, ANP-BC, FAANP, FAAN, dberry@email.unc.edu; Wanda M. Williams, RN, WHNP-BC
Abstract:
Session presented on Monday, July 25, 2016: Purpose: In 2013, approximately 382 million people over the age of 20 years were diagnosed with type 2 diabetes, and it is estimated that by 2035 that number will increase to 592 million worldwide (1). The majority of patients diagnosed with type 2 diabetes do not receive consistent medical care and education about the disease process and do not maintain good glycemic control (2,3). Poor glycemic control leads to microvascular and macrovascular complications (2). 'The purpose of this randomized controlled pilot study was to develop and test an interdisciplinary approach to diabetes self-management in a community-based health center serving underserved and uninsured minority patients. Methods: The primary outcome was glycated hemoglobin from baseline to 15 months. Secondary outcomes included lipids and blood pressure and diabetes self-management. 'A randomized repeated measures design was used with 40 patients in the experimental group and 40 patients in the control group. The patients in the experimental group were provided with a diabetes group visit which consisted of individualized sessions with a physician or nurse practitioner to review medications and conduct a medical examination and group sessions to deliver diabetes self-management education. The control group received usual care.' All 5 classes were delivered to each patient in the experimental group in the same order every 3 months for 15 months. Classes included understanding foot care, blood glucose monitoring, blood pressure and cholesterol, nutrition and exercise, and complications of diabetes. Data collected included clinical data and questionnaires every 3 months for 15 months. Data analysis was completed using ANOVA comparing Time 1 (baseline) data and Time 5 (15 month) data.' Results: The patients ranged in age from 32 to 65 years (mean ' SD years, 51.4 ' 8.5). A total of 89.3% were women and 10.7% men. The sample was 77.4% non-Hispanic Black, 17.9% non-Hispanic White, 2.4% bilingual Hispanic, 1.2% Asian Pacific, and 1.2% American Indian. A total of 54.2% had finished high school; 25.2% had finished 4 years of college; and 3.6% had finished graduate school. At the completion of Time 5 data, the experimental group retained 35 patients (88% retention rate), and the control group retained 33 patients (83% retention rate). The experimental group significantly decreased glycated hemoglobin (F = 12.8; p = .001) and triglycerides (F = 11.0; p = .002), increased high-density lipoprotein (F = 4.8; p = .033), and decreased resting heart rate (F = 4.9; p = .031) compared to the control group patients.' The patients in the experimental group felt their general health (F= 11.4; p = .001) was significantly better than the control group. In addition, the patients in the experimental group felt that they could do significantly more stretching and strengthening exercises each week (F = 10.4; p = .002) and felt significantly more confident (F = 4.7; p = .034) that they could exercise 15 to 20 minutes, 4-5 times a week. The patients in the experimental group also felt significantly more confident (F= 4.9; p = 0.03) that they could do something to prevent their blood sugar from dropping when they exercised. Conclusion: Diabetes group visits imbedded in a community health center improved metabolic control, high-density lipoproteins, triglycerides and some diabetes self-management behaviors.
Keywords:
diabetes self-management; optimizing diabetes self-management outcomes; type 2 diabetes mellitus
Repository Posting Date:
13-Jul-2016
Date of Publication:
13-Jul-2016 ; 13-Jul-2016
Other Identifiers:
INRC16P04; INRC16P04
Conference Date:
2016
Conference Name:
27th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Cape Town, South Africa
Description:
Theme: Leading Global Research: Advancing Practice, Advocacy, and Policy

Full metadata record

DC FieldValue Language
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleOptimizing Diabetes Self-Management Outcomes in Low-Income Ethnic Minority Patients in the United Statesen
dc.title.alternativeHealth Promotion in the Diabetic Patienten
dc.contributor.authorBerry, Diane C.en
dc.contributor.authorWilliams, Wanda M.en
dc.contributor.departmentAlpha Alphaen
dc.author.detailsDiane C. Berry, RN, ANP-BC, FAANP, FAAN, dberry@email.unc.edu; Wanda M. Williams, RN, WHNP-BCen
dc.identifier.urihttp://hdl.handle.net/10755/616374-
dc.description.abstractSession presented on Monday, July 25, 2016: Purpose: In 2013, approximately 382 million people over the age of 20 years were diagnosed with type 2 diabetes, and it is estimated that by 2035 that number will increase to 592 million worldwide (1). The majority of patients diagnosed with type 2 diabetes do not receive consistent medical care and education about the disease process and do not maintain good glycemic control (2,3). Poor glycemic control leads to microvascular and macrovascular complications (2). 'The purpose of this randomized controlled pilot study was to develop and test an interdisciplinary approach to diabetes self-management in a community-based health center serving underserved and uninsured minority patients. Methods: The primary outcome was glycated hemoglobin from baseline to 15 months. Secondary outcomes included lipids and blood pressure and diabetes self-management. 'A randomized repeated measures design was used with 40 patients in the experimental group and 40 patients in the control group. The patients in the experimental group were provided with a diabetes group visit which consisted of individualized sessions with a physician or nurse practitioner to review medications and conduct a medical examination and group sessions to deliver diabetes self-management education. The control group received usual care.' All 5 classes were delivered to each patient in the experimental group in the same order every 3 months for 15 months. Classes included understanding foot care, blood glucose monitoring, blood pressure and cholesterol, nutrition and exercise, and complications of diabetes. Data collected included clinical data and questionnaires every 3 months for 15 months. Data analysis was completed using ANOVA comparing Time 1 (baseline) data and Time 5 (15 month) data.' Results: The patients ranged in age from 32 to 65 years (mean ' SD years, 51.4 ' 8.5). A total of 89.3% were women and 10.7% men. The sample was 77.4% non-Hispanic Black, 17.9% non-Hispanic White, 2.4% bilingual Hispanic, 1.2% Asian Pacific, and 1.2% American Indian. A total of 54.2% had finished high school; 25.2% had finished 4 years of college; and 3.6% had finished graduate school. At the completion of Time 5 data, the experimental group retained 35 patients (88% retention rate), and the control group retained 33 patients (83% retention rate). The experimental group significantly decreased glycated hemoglobin (F = 12.8; p = .001) and triglycerides (F = 11.0; p = .002), increased high-density lipoprotein (F = 4.8; p = .033), and decreased resting heart rate (F = 4.9; p = .031) compared to the control group patients.' The patients in the experimental group felt their general health (F= 11.4; p = .001) was significantly better than the control group. In addition, the patients in the experimental group felt that they could do significantly more stretching and strengthening exercises each week (F = 10.4; p = .002) and felt significantly more confident (F = 4.7; p = .034) that they could exercise 15 to 20 minutes, 4-5 times a week. The patients in the experimental group also felt significantly more confident (F= 4.9; p = 0.03) that they could do something to prevent their blood sugar from dropping when they exercised. Conclusion: Diabetes group visits imbedded in a community health center improved metabolic control, high-density lipoproteins, triglycerides and some diabetes self-management behaviors.en
dc.subjectdiabetes self-managementen
dc.subjectoptimizing diabetes self-management outcomesen
dc.subjecttype 2 diabetes mellitusen
dc.date.available2016-07-13T11:11:06Z-
dc.date.issued2016-07-13-
dc.date.issued2016-07-13en
dc.date.accessioned2016-07-13T11:11:06Z-
dc.conference.date2016en
dc.conference.name27th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationCape Town, South Africaen
dc.descriptionTheme: Leading Global Research: Advancing Practice, Advocacy, and Policyen
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.