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Klein HA, Jackson SM, Street K, et al. Diabetes self-management education: miles to go. Nurs Res Pract. 2013;2013:581012doi: 10.1155/2013/581012.
Klein, H. A., Jackson, S. M., Street, K., Whitacre, J. C., & Klein, G. (2013). Diabetes self-management education: miles to go. Nursing research and practice, 2013581012. https://doi.org/10.1155/2013/581012
Klein, Helen Altman, et al. "Diabetes self-management education: miles to go." Nursing research and practice vol. 2013 (2013): 581012. doi: https://doi.org/10.1155/2013/581012
Klein HA, Jackson SM, Street K, Whitacre JC, Klein G. Diabetes self-management education: miles to go. Nurs Res Pract. 2013;2013:581012. doi: 10.1155/2013/581012. Epub 2013 Mar 20. PMID: 23577243; PMCID: PMC3616351.
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Nurs Res Pract. 2013;2013:581012. doi: 10.1155/2013/581012. Epub 2013 Mar 20.

Diabetes self-management education: miles to go.

Nursing research and practice

Helen Altman Klein, Sarah M Jackson, Kenley Street, James C Whitacre, Gary Klein

Affiliations

  1. Division of Research, MacroCognition LLC, P.O. Box 533, Yellow Springs, OH 45387, USA.

PMID: 23577243 PMCID: PMC3616351 DOI: 10.1155/2013/581012

Abstract

This meta-analysis assessed how successfully Diabetes Self-Management Education (DSME) interventions help people with type 2 diabetes achieve and maintain healthy blood glucose levels. We included 52 DSME programs with 9,631 participants that reported post-intervention A1c levels in randomized controlled trials. The training conditions resulted in significant reductions in A1c levels compared to control conditions. However, the impact of intervention was modest shifting of only 7.23% more participants from diabetic to pre-diabetic or normal status, relative to the control condition. Most intervention participants did not achieve healthy A1c levels. Further, few DSME studies assessed long-term maintenance of A1c gains. Past trends suggest that gains are difficult to sustain over time. Our results suggested that interventions delivered by nurses were more successful than those delivered by non-nursing personnel. We suggest that DSME programs might do better by going beyond procedural interventions. Most DSME programs relied heavily on rules and procedures to guide decisions about diet, exercise, and weight loss. Future DSME may need to include cognitive self-monitoring, diagnosis, and planning skills to help patients detect anomalies, identify possible causes, generate corrective action, and avoid future barriers to maintaining healthy A1c levels. Finally, comprehensive descriptions of DSME programs would advance future efforts.

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