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Self-monitoring of blood glucose--psychological aspects relevant to changes in HbA1c in type 2 diabetic patients treated with diet or diet plus oral antidiabetic medication.
Patient Educ Couns. 2006 Jul; 62(1):104-10.PE

Abstract

OBJECTIVE

To investigate the influence of psychological aspects on glycemic control in type 2 diabetic patients treated with diet alone or diet plus oral antidiabetic medication using meal-related self-monitoring of blood glucose (SMBG). These psychological aspects refer to the process of self-management including the tendency to structure situations and activate resources (self-perception), to accept options for action (self-reflection) and to believe in self-efficacy (self-regulation).

METHODS

In a randomized controlled 6-month group comparison study, one group (n = 113; mean age 58.7 years) used a blood glucose monitoring device, kept a blood glucose/eating diary and received standardized counseling focusing on self-perception, self-reflection and self-regulation. A control group (n = 110; mean age 60.5 years) received non-standardized counseling on diet and lifestyle.

RESULTS

Statistically significant endpoint differences between the SMBG and the control group were seen in glycemic control (p = 0.0086) and the well-being item 'depression' (p = 0.032). All aspects of counseling were influenced by SMBG with the extent of self-perception and self-reflection gradually increasing over time. Three HbA1c response types were identified among SMBG patients: continuous-achievers, late-achievers and non-achievers.

CONCLUSION

This study identified processes (structuring the situation and activating resources, accepting options for action and believing in self-efficacy) which lead to a change in the metabolic profile. SMBG coupled with structured counseling provided patients with a tool for taking on more self-control and resulted in an improved outlook on life.

PRACTICE IMPLICATIONS

This short-term intervention involved a structured counseling algorithm which requires 5-10 min of physician-patient contact and a structured documentation of metabolic control by the patient and can be taught by a diabetes training team within 4 h. The identification of the different response types might be of importance in clinical practice as it enables the physician to determine the right counseling option.

Authors+Show Affiliations

Catholic University of Applied Sciences Nordrhein Westfalen, Department of Health Care Systems, Woerthstrasse 10, D-50668 Köln, Cologne, Germany. M.Siebolds@KFHNW.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16159705

Citation

Siebolds, Marcus, et al. "Self-monitoring of Blood Glucose--psychological Aspects Relevant to Changes in HbA1c in Type 2 Diabetic Patients Treated With Diet or Diet Plus Oral Antidiabetic Medication." Patient Education and Counseling, vol. 62, no. 1, 2006, pp. 104-10.
Siebolds M, Gaedeke O, Schwedes U, et al. Self-monitoring of blood glucose--psychological aspects relevant to changes in HbA1c in type 2 diabetic patients treated with diet or diet plus oral antidiabetic medication. Patient Educ Couns. 2006;62(1):104-10.
Siebolds, M., Gaedeke, O., & Schwedes, U. (2006). Self-monitoring of blood glucose--psychological aspects relevant to changes in HbA1c in type 2 diabetic patients treated with diet or diet plus oral antidiabetic medication. Patient Education and Counseling, 62(1), 104-10.
Siebolds M, et al. Self-monitoring of Blood Glucose--psychological Aspects Relevant to Changes in HbA1c in Type 2 Diabetic Patients Treated With Diet or Diet Plus Oral Antidiabetic Medication. Patient Educ Couns. 2006;62(1):104-10. PubMed PMID: 16159705.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-monitoring of blood glucose--psychological aspects relevant to changes in HbA1c in type 2 diabetic patients treated with diet or diet plus oral antidiabetic medication. AU - Siebolds,Marcus, AU - Gaedeke,Oliver, AU - Schwedes,Ulrich, AU - ,, Y1 - 2005/09/12/ PY - 2004/12/10/received PY - 2005/06/14/revised PY - 2005/06/27/accepted PY - 2005/9/15/pubmed PY - 2006/8/26/medline PY - 2005/9/15/entrez SP - 104 EP - 10 JF - Patient education and counseling JO - Patient Educ Couns VL - 62 IS - 1 N2 - OBJECTIVE: To investigate the influence of psychological aspects on glycemic control in type 2 diabetic patients treated with diet alone or diet plus oral antidiabetic medication using meal-related self-monitoring of blood glucose (SMBG). These psychological aspects refer to the process of self-management including the tendency to structure situations and activate resources (self-perception), to accept options for action (self-reflection) and to believe in self-efficacy (self-regulation). METHODS: In a randomized controlled 6-month group comparison study, one group (n = 113; mean age 58.7 years) used a blood glucose monitoring device, kept a blood glucose/eating diary and received standardized counseling focusing on self-perception, self-reflection and self-regulation. A control group (n = 110; mean age 60.5 years) received non-standardized counseling on diet and lifestyle. RESULTS: Statistically significant endpoint differences between the SMBG and the control group were seen in glycemic control (p = 0.0086) and the well-being item 'depression' (p = 0.032). All aspects of counseling were influenced by SMBG with the extent of self-perception and self-reflection gradually increasing over time. Three HbA1c response types were identified among SMBG patients: continuous-achievers, late-achievers and non-achievers. CONCLUSION: This study identified processes (structuring the situation and activating resources, accepting options for action and believing in self-efficacy) which lead to a change in the metabolic profile. SMBG coupled with structured counseling provided patients with a tool for taking on more self-control and resulted in an improved outlook on life. PRACTICE IMPLICATIONS: This short-term intervention involved a structured counseling algorithm which requires 5-10 min of physician-patient contact and a structured documentation of metabolic control by the patient and can be taught by a diabetes training team within 4 h. The identification of the different response types might be of importance in clinical practice as it enables the physician to determine the right counseling option. SN - 0738-3991 UR - https://www.unboundmedicine.com/medline/citation/16159705/Self_monitoring_of_blood_glucose__psychological_aspects_relevant_to_changes_in_HbA1c_in_type_2_diabetic_patients_treated_with_diet_or_diet_plus_oral_antidiabetic_medication_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0738-3991(05)00192-8 DB - PRIME DP - Unbound Medicine ER -