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Self-regulation and weight reduction in patients with type 2 diabetes: a pilot intervention study [with consumer summary]
Huisman S, de Gucht V, Maes S, Schroevers M, Chatrou M, Haak H
Patient Education and Counseling 2009 Apr;75(1):84-90
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the efficacy of a self-regulation (SR) weight reduction intervention on weight, body mass index (BMI), glycosylated hemoglobin (HbA1c) (primary outcomes), exercise, nutrition and quality of life (secondary outcomes). METHODS: A pilot intervention (n = 53) based on SR-principles consisted of a motivational interview, group sessions and a workbook and was evaluated against standard care with (n = 38) and without a self-help manual (n = 38). Subjects were overweight (BMI > 27) patients with type 2 diabetes (52% female) from a Dutch hospital (mean age 58.14, SD 8.86). RESULTS: No differences in the outcomes were found between the intervention and control groups at 3 (T2) or 6 (T3) months. However, results at T2 and T3 revealed that patients with higher SR-skills scores had lower HbA1c levels than patients with lower scores. CONCLUSION: The SR-intervention did not significantly influence the outcomes. This apparent lack of effect might, however, partly be due to high attrition rates in all treatment groups. SR-skills were positively related to changes in HbA1c-levels. PRACTICE IMPLICATIONS: Improving SR-skills of overweight diabetes type 2 patients may improve their glycemic control. Patients who are 'external regulators' may however profit more from directive than from SR-interventions.
With permission from Excerpta Medica Inc.

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