Effectiveness of Diabetes Self-Management Education on glycaemic control in patients with T2DM

Abstract

Background: The prevalence of diabetes mellitus has been rising rapidly in middle- and low-income countries. In Ghana, about 70% of people with diabetes mellitus have poor glycaemic control. This necessitates effective diabetes control measures including Diabetes self-management education (DSME) which is useful in improving patient outcomes. Aim: To determine the effectiveness of diabetes self-management education on glycaemic control when combined with usual care versus usual care alone in patients with Type 2 diabetes mellitus (T2DM). Methods: This was a parallel-group, 2-arm randomized controlled trial among 74 sub-optimally controlled (HbA1c > 7.9%) T2DM patients to assess the effectiveness of a nurse-led 6-month DSME plus usual care (intervention) on glycaemic control compared to usual care alone. The primary outcome was the mean change in HbA1c at 6 months. The secondary outcomes included mean change in FBG at 3 months and mean changes in blood pressure, body weight and LDL-C at 6 months. Wilcoxon rank sum tests were used to test differences in the paired samples to assess the mean change in parameters between the two groups post-intervention. To estimate the effect of the intervention on glycaemic outcomes, inverse probability weighted (IPW) linear regression was conducted, incorporating stabilized weights derived from a propensity score model. Statistical significance for all tests was set at the 0.05 level.