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Motivational interviewing delivered by diabetes educators: does it improve blood glucose control among poorly controlled type 2 diabetes patients? |
Welch G, Zagarins SE, Feinberg RG, Garb JL |
Diabetes Research and Clinical Practice 2011 Jan;91(1):54-60 |
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* |
AIM: To determine whether glycemic control is improved when motivational interviewing (MI), a patient-centered behavior change strategy, is used with diabetes self management education (DSME) as compared to DSME alone. METHODS: Poorly controlled type 2 diabetes (T2DM) patients (n = 234) were randomized into 4 groups: MI+DSME or DSME alone, with or without use of a computerized summary of patient self management barriers. We compared HbA1c changes between groups at 6 months and investigated mediators of HbA1c change. RESULTS: Study patients attended the majority of the four intervention visits (mean 3.4), but drop-out rate was high at follow-up research visits (35%). Multiple regression showed that groups receiving MI had a mean change in HbA1c that was significantly lower (less improved) than those not receiving MI (t = 2.10; p = 0.037). Mediators of HbA1c change for the total group were diabetes self-care behaviors and diabetes distress; no between-group differences were found. CONCLUSIONS: DSME improved blood glucose control, underlining its benefit for T2DM management. However, MI+DSME was less effective than DSME alone. Overall, weak support was found for the clinical utility of MI in the management of T2DM delivered by diabetes educators.
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