New programme sees success in achieving type 2 diabetic lifestyle changes

by Barbara Hewitt on August 15, 2014

A holistic programme which gives type 2 diabetics more knowledge about their condition and helps them understand how to manage it could improve their health, it is claimed.

A study led by nurse educators at New York Presbyterian Hospital’s ambulatory care network has found that enrolling diabetics in a self-management and education programme helps to reduce blood sugar, blood pressure and cholesterol levels.


The programme helped reduce blood sugar, blood pressure and cholesterol levels

Some 1,263 diabetic patients in a low income immigrant population in northern Manhattan underwent a comprehensive initial assessment and received four 30 minute individual sessions with a diabetes nurse educator, followed by group sessions focused on reinforcing self-management and individual goals.

The individual patient sessions concentrated on helping them achieve their goals, while group sessions helped give them a deeper understanding of their condition and the implications of their actions.

The programme concentrated on seven points; healthy eating, physical activity, monitoring vital signs, medication management, problem solving, healthy coping and risk reduction.

Using the holistic medical home approach to care, patients were referred to specialty services, such as endocrinologists, ophthalmologists, podiatrists, dentists, dietitians, social workers and other providers on an as needed basis.

‘Apart from assessing a patient’s physical condition, nurse educators asked patients questions, actively listened to their responses and engaged them in conversation to capture critical information about their lifestyle and eating habits, medication adherence and stress management,’ said Yesenia Cabral, the network’s disease care manager.

‘For example, since most patients forget to take their medication from time to time, we talk about what actually happens to the body when it doesn’t receive the proper medication dosage at the proper time. That really hits home the importance of compliance. As nurses, we believe that organised patient education can empower patients and lead to better outcomes,’ she added.

After 15 months, participants on average lowered their blood sugar levels by 67% and their LDL cholesterol levels by 53%. Some 32% had high blood pressure at the start of the study, but this was reduced to 25% at the end.

There was a 7% increase in participants with a recommended AIC below 7% at the conclusion of the study. The A1C test, which measures blood glucose levels, is an indicator of how well diabetes is being managed.

‘What sets this programme apart is its patient-centred approach. Nurse educators forge a strong bond with patients to help them build a foundation of knowledge and a sense of control over their condition, which allows them to manage the myriad challenges they face in making powerful changes to keep diabetes under control and avoid complications,’ said the study’s lead investigator, Lovelyamma Varghese.

‘We are able to go into their homes, speak their language and identify opportunities for behavioural changes. It’s was a win-win partnership for everyone,’ she explained, adding that as a result of the study’s impressive results, best practices from this programme are being implemented throughout New York-Presbyterian/Ambulatory Care Network.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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