Abstract
The purpose of this study was to evaluate the efficacy and feasibility of a newly developed diabetes patient education program consisting of a three-day hospitalization and a six-month follow-up by telephone counseling for patients with mild type 2 diabetes or impaired glucose tolerance (IGT) by a randomized controlled trial (RCT) method. Fifty-two patients with mild type 2 diabetes or IGT (HbAlc<8) were randomly assigned to either an intervention group or a control group. The current care was continued for the control group and the new education program was provided in addition to the current care for the intervention group. Changes in weight, blood glucose in a 75g-oral glucose tolerance test (75g-OGTT), and HbAlc were measured in June 1997 as baseline data and again in Dec. 1997. Scores for knowledge of diabetes, dietary habits, physical activity, health practice index, diabetes quality of life (DQOL), and self-efficacy were also obtained. After six months, the intervention group showed a statistically significant weight loss and blood glucose reduction in the 75g-OGTT test, but the control group did not. A significant improvement in lifestyle was observed in the intervention group, especially in terms of dietary habits and physical activity. The knowledge test scores increased in both groups. There were no significant differences in HbAlc, DQOL, or self-efficacy between the two groups. The results of this study show that the combination of a three-day hospitalization and a six-month follow-up by telephone counseling is effective in metabolic control and improvement of lifestyle for patients with mild type 2 diabetes or IGT. The reasons for the effectiveness were considered to be that l)changes in lifestyle were based on autonomous decision-making; 2)regular, consistent counseling was provided by the nurse in charge of each patient; 3)extended follow-up is more effective than initial education in preventing a rebound of weight or metabolic control.
Key words: randomized controlled trial, type 2 diabetes, IGT, patient education, telephone counseling
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