Study on the long-term and short-term effects of community-based health self-management group activities on comprehensive control of type 2 diabetes^☆

Abstract

Background: Diabetes self-management is an important measure to reduce the adverse impact of the disease and improve the outcome in patients with diabetes. Existing diabetes self-management studies mainly focus on the evaluation of short-term intervention effects, but rarely report the long-term effects.
Objective: To evaluate the short- and long-term effects of self-management group activities on comprehensive glycemic control in patients with type 2 diabetes in the community.
Methods: In 2014, 500 adults with type 2 diabetes were recruited from Fangshan District, Beijing, and were randomly divided into a control group(n = 241) and an intervention group(n = 259). Both groups received routine diabetes follow-up services. The intervention group also received a three-month self-management group activities. We conducted four surveys at different times(at baseline, three months, two years and five years post-intervention) to collect patient demographics, disease condition, comprehensive glycemic control indicators〔body mass index(BMI), blood pressure, fasting plasma glucose(FPG), glycated hemoglobin(HbA1c), high-density lipoprotein cholesterol(HDL-C), triacylglycerol(TG), low-density lipoprotein cholesterol(LDL-C)〕. Generalized estimating equations were used to analyze the main effect of the self-management activities and the interaction effect of the activities with post-intervention time.
Results: After adjusting for potential confounders, the main effects of the self-management activities on BMI, systolic blood pressure, diastolic blood pressure, FPG, HbA1c, HDL-C, TG an LDL-C were not statistically significant(P > 0.05). The main effects of post-intervention time on various indicators were statistically significant(P < 0.05). Specifically, BMI, systolic blood pressure, diastolic blood pressure, FPG, HbA1c, HDL-C and LDL-C increased, and TG decreased in the patients after intervention. We found the self-management activities and the post-intervention time had an interaction effect on BMI〔β(95 %CI)=-0.33(-0.62, -0.05)〕, FPG〔β(95 %CI)=-1.03(-1.71, -0.35)〕, and TG〔β(95 %CI)=-0.54(-0.93, -0.14)〕: the BMI of the intervention group was 0.31 kg/m² lower than that of the control group at baseline, but was 0.64 kg/m² lower than that of the control group at three months post-intervention; the FPG of the intervention group was 0.19 mmol/L higher than that of the control group at baseline, but was 0.84 mmol/L lower than that of the control group at two years post-intervention; the TG of the intervention group was 0.03 mmol/L higher than that of the control group at baseline, but was 0.51 mmol/L lower than that of the control group at five years post-intervention.
Conclusion: Self-management group activities have a short-term effect on controlling BMI, and may have a long-term effect on controlling FPG and TG in patients with type 2 diabetes.

Keywords

Diabetes mellitus / Type 2 / Self-management / Long-term effects / Follow-up studies / Community health services / Generalized estimating equations

Declarations

Not applicable.

Authors' contributions

Conceptualization, X.Z.; Methodology, X.Z.; Data curation, M.F., J.Y. and D.W.; Formal analysis, X.Z.; Funding acquisition, D.J.; Project administration, M.F. and J.Y.; Resources, D.J.; Supervision, M.F., J.Y. and D.W.; Validation, D.J.; Writing—original draft, X.Z.; Writing—review and editing, D.J. All authors have read and agreed to the published version of the manuscript.

Ethics approval and consent to participate

This research was supported by grants from Control and Evaluation, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention(Ethics Review No. 201,909).

Consent for publication

Not applicable.

Availability of data and materials

Not applicable.

Authors' other information

Not applicable.

Funding

This research was supported by grants from Ministry of Science and Technology of the People's Republic of China (2020YFC2006403) (2020YFC2006400) and Chinese Center for Disease Control and Prevention (M-1-2019-10-005).

Competing interests

The authors declare that they have no competing interests.

Acknowledgements

Not applicable.

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