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[Improvement of control in subjects with type 2 diabetes after a joint intervention: diabetes education and physical
Consuelo Ariza Copado1, Vicente Gavara Palomar, Alfonso Muñoz Ureña
1Centro de Salud Isaac Peral, Cartagena, Murcia, España. cheloariza@yahoo.es
Objective:
To study the improvement of metabolic control and cardiovascular risk factors, adherence, self-monitoring, self-care, attitudes and motivation in subjects with Type 2 Diabetes (DM2) in a specific Health Care Area after group intervention through the community: diabetes education (DE) and physical exercise (PE).
Design:
A single blind, randomised controlled clinical trial.
Intervention:
group 1: DE; group 2: ED and PE; group 3: only PE, and "control" group-4: Individual consultations.
Location:
Urban health centre/municipal sports centre.
Participants:
108 DM2, age: 40-70, glycated haemoglobin (HbA(1)c) ≤ 8.5%, blood pressure (BP)<160/90 and body mass index (BMI)<45, excluding those with chronic complications and/or acute decompensation.
Interventions:
During 6 months, 8 workshops were held for group education and monitored aerobic physical exercise of moderate intensity (3 hours a week).
Main Measurements:
Primary variable pre- and post- intervention: reduction in HbA(1)c; other variables: examination and analytical data, therapeutic compliance, self-monitoring, self-care, attitudes and motivation (DAS-3SP survey).
Results:
After intervention, more diabetics had a lower HbA(1)c following a full intervention: "DE" and "PE", RR: 1.93 (0.85-4.40) and exercise, RR: 1.56 (0.65-3.76). With simultaneous DE and PE, the BMI, RR: 1.61 (0.85-3.03) and LDL cholesterol, RR: 1.82 (0.99-3.36), of many subjects decreased. Dietary compliance, RR: 1.29 (0.32-5.22) and exercise, RR: 1.93 (0.76-4.91) also increased, more patients performing their own checks, RR: 3.86 (0.90-16.55) and improving motivation/attitudes in "strict control management", RR: 1.48 (0.94-2.34). With PE, systolic and diastolic BP decreased in more patients RR: 1.35 (0.72-2.52), 1.87 (0.72-4.84) while in the DE group only diastolic values decreased 1.80 (0.69-4.67).
Conclusions:
Patient conditions improve more with the combination of DE and PE, though the results are not statistically significant, probably due to insufficient sample size.
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