Dataset Information

Identification of Education Models to Improve Health Outcomes in Arab Women with Pre-Diabetes.

ABSTRACT: Few evaluations of interventions to delay or prevent type 2 diabetes mellitus (T2DM) in Saudi Arabia (SA) have been undertaken. The present study evaluates the impact of a 6-month intensive lifestyle modification intervention delivered in primary care. Females from SA with prediabetes, aged 18-55 years, were recruited with 190 participants eligible following screening and randomly allocated to receive a 3-month one-on-one, intensive lifestyle modification (intervention group (IG) n = 95) or standard guidance (control group (CG) n = 95). Participants completed questionnaires including demographic, dietary and physical activity data. Blood samples were collected at baseline, 3 and 6 months. A total of 123 (74 IG (age 40.6 ± 9.8 years; body mass index (BMI) 31.2 ± 7.0 kg/m2) and 49 CG (age 40.6 ± 12.7 years; BMI 32.3 ± 5.4 kg/m2)) participants completed the study. After 6 months, haemoglobin A1c (HbA1c; primary endpoint) significantly improved in the IG than CG completers in between-group comparisons (p < 0.001). Comparison between groups showed significant improvements in overall energy intake, total and high density lipoprotein (HDL)-cholesterol in favour of IG (p-values < 0.001, 0.04 and <0.001, respectively). BMI and weight change were not clinically significant in between group comparisons. A 6-month, intense one-on-one intervention in lifestyle modification significantly improves glycaemic and cardio metabolic profile of females living in SA with pre-diabetes delivered in a primary care setting. Longer duration studies, using the same intervention, may determine whether a meaningful weight loss secondary to improved diet can be achieved.

SUBMITTER: Al-Hamdan R

PROVIDER: S-EPMC6566809 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Identification of Education Models to Improve Health Outcomes in Arab Women with Pre-Diabetes.

Al-Hamdan Rasha R Avery Amanda A Salter Andrew A Al-Disi Dara D Al-Daghri Nasser M NM McCullough Fiona F

Nutrients 20190518 5

Few evaluations of interventions to delay or prevent type 2 diabetes mellitus (T2DM) in Saudi Arabia (SA) have been undertaken. The present study evaluates the impact of a 6-month intensive lifestyle modification intervention delivered in primary care. Females from SA with prediabetes, aged 18-55 years, were recruited with 190 participants eligible following screening and randomly allocated to receive a 3-month one-on-one, intensive lifestyle modification (intervention group (IG) <i>n</i> = 95) ...[more]

PMID: 31109110

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Project description:BackgroundEffective type 2 diabetes care remains a challenge for patients including those receiving primary care in safety net settings.ObjectiveThe Partnership to Improve Diabetes Education (PRIDE) trial team and leaders from a regional department of health evaluated approaches to improve care for vulnerable patients.DesignCluster randomized controlled trial.PatientsAdults with uncontrolled type 2 diabetes seeking care across 10 unblinded, randomly assigned safety net clinics in Middle TN.InterventionsA literacy-sensitive, provider-focused, health communication intervention (PRIDE; 5 clinics) vs. standard diabetes education (5 clinics).Main measuresParticipant-level primary outcome was glycemic control [A1c] at 12 months. Secondary outcomes included select health behaviors and psychosocial aspects of care at 12 and 24 months. Adjusted mixed effects regression models were used to examine the comparative effectiveness of each approach to care.Key resultsOf 410 patients enrolled, 364 (89%) were included in analyses. Median age was 51 years; Black and Hispanic patients represented 18% and 25%; 96% were uninsured, and 82% had low annual income level (< $20,000); adequate health literacy was seen in 83%, but numeracy deficits were common. At 12 months, significant within-group treatment effects occurred from baseline for both PRIDE and control sites: adjusted A1c (- 0.76 [95% CI, - 1.08 to - 0.44]; P < .001 vs - 0.54 [95% CI, - 0.86 to - 0.21]; P = .001), odds of poor eating (0.53 [95% CI, 0.33-0.83]; P = .01 vs 0.42 [95% CI, 0.26-0.68]; P < .001), treatment satisfaction (3.93 [95% CI, 2.48-6.21]; P < .001 vs 3.04 [95% CI, 1.93-4.77]; P < .001), and self-efficacy (2.97 [95% CI, 1.89-4.67]; P < .001 vs 1.81 [95% CI, 1.1-2.84]; P = .01). No significant difference was observed between study arms in adjusted analyses.ConclusionsBoth interventions improved the participant's A1c and behavioral outcomes. PRIDE was not more effective than standard education. Further research may elucidate the added value of a focused health communication program in this setting.

Project description:BackgroundEducation during pregnancy is important for the development of the pregnant woman's ability to adapt to change and for a healthy birth. In this study, we aimed to examine the effects of education through a diabetes education program on maternal and newborn health in women diagnosed with gestational diabetes.Materials and methodsIn our study, we compared the maternal and neonatal health outcomes of pregnant women who participated in the diabetes education program and were diagnosed with gestational diabetes with the outcomes of pregnant women who did not participate in the diabetes education program and were diagnosed with gestational diabetes. The study included patients who were diagnosed with diabetes between 24and 26 weeks gestation at a tertiary education and research hospital and who underwent a 75-gram OGTT test. Age, BMI, parity, method of delivery, weight gain during pregnancy, newborn birth weight, gestational age and Apgar scores were compared.ResultsThe study included 119 patients and analyzed maternal-neonatal outcomes. There were no statistically significant differences in age (33 ± 5.7 versus 31 ± 5.2), body mass index (BMI) (32.2 vs. 31.2), gravidity, parity, number of miscarriages, mode of delivery, family history of diabetes, smoking, prenatal corticosteroid use, and gestational age at delivery. The HbA1c value (p: 0.013), the total weight gain during pregnancy (p: 0.015), the need for insulin treatment (p: 0.002), and the birth weight (0.005) were significantly higher in the group without diabetes education.ConclusionIn our study, diabetic school education was associated with lower HbA1c levels, less weight gain and less need for insulin therapy. When the results were categorized by insulin use, it was found that in patients using insulin, those who received diabetic school education had fewer macrosomic fetuses, whereas in patients not using insulin, those who received diabetic school education had lower maternal weight gain during pregnancy.

Project description:BackgroundDiabetes is an important health burden in Indonesia. However, diabetes management and treatment remain poor, with most people with diabetes in Indonesia not achieving the recommended blood glucose levels. Peer education may have particular potential in low-income settings in complementing diabetes care without being a large additional strain on the health system.Methods/designThis cluster randomized controlled trial aims to identify the effect of the implementation of peer education for patients with type 2 diabetes on diabetes-related outcomes in Aceh, Indonesia, which will complement the diabetes treatment provided at primary-care health posts (puskesmas). Altogether, 29 puskesmas were recruited in Banda Aceh and Aceh Besar, each of which was randomly assigned to either the control or the intervention group. Then, 534 people with diabetes were identified and recruited through their respective puskesmas. The intervention consists of up to two peer education groups per puskesmas, which are led by previously trained people with diabetes. Peer education sessions are held every month for 18 months, with follow-up data being collected 9 and 18 months after the first peer education session. The main objective is to improve diabetes management and the health behavior of participants receiving peer education to reduce their average blood glucose levels as measured by glycated hemoglobin (HbA1c) levels. Secondary outcomes are the effects of peer education on lipid levels, waist circumference, blood pressure, quality of life, treatment adherence, diabetes knowledge, physical activity, and dietary diversity. Data sources for the measurement of outcomes include patient and health facility surveys and biomarker measurements. An economic evaluation will be conducted to assess the cost-effectiveness of the intervention.DiscussionThis trial will contribute to the evidence on the effectiveness and cost-effectiveness of peer education in improving diabetes management in a low-income setting in Indonesia and in other comparable contexts.Trial registrationISRCTN registry, ISRCTN68253014 . Registered on 18 February 2019.

Project description:BackgroundWorldwide, 199.5 million women have diabetes mellitus (DM). Preconception care (PCC) education starting from adolescence has been recommended as an effective strategy for safeguarding maternal and child health. However, traditional preconception care advice provided by health care professionals (HCPs) within clinic settings is hindered by inadequate resources, suboptimal coverage, and busy clinics. Electronic health (eHealth), which is instrumental in solving problems around scarce health resources, could be of value in overcoming these limitations and be used to improve preconception care and pregnancy outcomes for women with DM.ObjectiveThe objectives were to: (1) identify, summarize, and critically appraise the current methods of providing PCC education; (2) examine the relationship between PCC educational interventions (including use of technology as an intervention medium) on patient and behavioral outcomes; and (3) highlight limitations of current interventions and make recommendations for development of eHealth in this field.MethodsElectronic databases were searched using predefined search terms for PCC education in women with type 1 or 2 DM for quantitative studies from 2003 until June 2016. Of the 1969 titles identified, 20 full papers were retrieved and 12 papers were included in this review.ResultsThe reviewed studies consistently reported that women receiving educational interventions via health care professionals and eHealth had significantly improved levels of glycosylated hemoglobin (P<.001) with fewer preterm deliveries (P=.02) and adverse fetal outcomes (P=.03). Significant improvements in knowledge (P<.001) and attitudes toward seeking PCC (P=.003) were reported along with reduced barriers (P<.001).ConclusionsPCC has a positive effect on pregnancy outcomes for women with DM. However, uptake of PCC is low and the use of eHealth applications for PCC of women with DM is still in its infancy. Initial results are promising; however, future research incorporating mobile phones and apps is needed. Clearly, there is much to be done if the full potential of eHealth PCC to improve obstetric outcomes for women with DM is to be realized.

Dataset Information

Identification of Education Models to Improve Health Outcomes in Arab Women with Pre-Diabetes.

Publications

Identification of Education Models to Improve Health Outcomes in Arab Women with Pre-Diabetes.

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