In a nutshell
This review examined the factors which make a behavioral program for type 2 diabetes management effective. The authors concluded that patients who have poorly controlled diabetes are likely to gain the greatest benefit.
Some background
Patients with type 2 diabetes (T2D) are encouraged to eat healthily and increase physical activity. T2D patients are also encouraged to monitor blood glucose (sugar) levels and take medication. Behavioral programs have been established to support diabetes management and improve outcomes.
There are a wide variety of behavioral programs available. Behavioral programs may include diabetes self-management education (DSME) with or without additional support. Other behavioral programs focus on improving lifestyle. It is not known which program combination is most effective. In addition, factors such as age may contribute to the effectiveness of a program. The HbA1c (average blood glucose levels over 3 months) may also influence the effectiveness of a program.
Methods & findings
This review aimed to determine which components make a behavioral program for T2D most effective.
This review summarized findings from 132 published trials. All trials included adults with T2D. All trials compared the effectiveness of behavioral programs to usual diabetes care.
Improvements in control of blood glucose levels were observed in most DSME programs with support (clinical or behavioral). Improvements in control of blood glucose levels were also observed in most lifestyle programs. In contrast, little benefit was observed in DSME programs which provided less than 10 hours of additional support.
The greater reduction in body mass index (measure of body fat based on weight and height) occurred in the lifestyle program. Participants who had an HbA1c greater than 7% experienced a greater benefit compared to those who had good control. Behavioral programs were most effective in adults younger than 65 years of age.
The bottom line
This review concluded that control of blood glucose levels and age influence the effectiveness of a behavioral program.
The fine print
The majority of the trials evaluated did not assess the long-term effectiveness of the behavioral program.
What’s next?
Consult your physician regarding the various behavioral programs available for T2D patients.
Published By :
Annals of internal medicine
Date :
Sep 29, 2015
