Abstract
Background: Group-based diabetes self-management education (DSME) programmes have been shown to be effective. A programme tailored for the unique social and ethnic environment of New Zealand (NZ) was developed using concepts from internationally developed programmes.
Aim: To assess the effectiveness of a 6 week New Zealand specific DSME programme.
Methods: In this observational study people with type 2 diabetes (aged 18-80 years) from diverse cultural backgrounds were recruited from primary care. Seventeen groups of six education sessions were run. Clinical data were collected from primary care at baseline, 3, 6 and 9 months. Participants also completed a self-administered questionnaire on diabetes knowledge, and self-management behaviours.
Results: 107 participants, mean age 56.7 +/- 11.3 years and mean duration of diabetes 7.5 +/- 7 years (NZ European (44%), Maori (24%), Pacific (16%) and Indian (16%)), were enrolled. Confidence in self-managing diabetes, regular examination of feet, physical activity levels and smoking rates all improved. Glycaemic control improved between baseline and 6 months (HbA(1c) 64.9 +/- 20.0 mmol/mol to 59.9 +/- 13.9 mmo/mol (p<0.05) (baseline 8.07% 1.80, 6 months 7.62% 1.25)), but was no different to baseline at 9 months. Systolic BP reduced from 131.9 +/- 16.4 to 127.4 +/- 18.2 mmHg (p<0.05) at 6 months, but increased to baseline levels by 9 months. Diastolic BP, triglycerides and urine microalbumin:creatinine ratio were significantly reduced at 3, 6 and 9 months.
Conclusion: A group-based DSME programme designed specifically for the NZ population was effective at improving aspects of diabetes care at 6 months. The attenuation of these improvements after 6 months suggests a refresher course at that time may be beneficial. (C) 2013 Published by Elsevier Ltd on behalf of Primary Care Diabetes Europe.