The Effect of Nurse-led Diabetes Self-management Education on Glycosylated Hemoglobin and Cardiovascular Risk Factors: A Meta-analysis
Purpose The purpose of this meta-analysis was to determine the effect of nurse-led diabetes self-management education (DSME) on blood glucose control and cardiovascular risk factors. Methods The electronic databases PubMed and ISIS Knowledge were searched for relevant randomized controlled studies p...
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| Veröffentlicht in: | The Diabetes educator 2012-01, Vol.38 (1), p.108-123 |
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| creator | Tshiananga, Jacques Kande Tshiang Kocher, Serge Weber, Christian Erny-Albrecht, Katrina Berndt, Karsten Neeser, Kurt |
| description | Purpose
The purpose of this meta-analysis was to determine the effect of nurse-led diabetes self-management education (DSME) on blood glucose control and cardiovascular risk factors.
Methods
The electronic databases PubMed and ISIS Knowledge were searched for relevant randomized controlled studies published between 1999 and 2009. Effect size was calculated for change in A1C, blood pressure, and lipid levels using both fixed- and random-effects models. Subgroup analyses were performed on patient age, gender, diabetes type, baseline A1C, length of follow-up, and study setting.
Results
A total of 34 randomized controlled trials with a combined cohort size of 5993 patients was identified. Mean patient age was 52.8 years, 47% were male, and mean A1C at baseline was 8.5%. Mean change in A1C was a reduction by −0.70% for nurse-led DSME versus −0.21% with usual care (UC). This corresponded to an effect size of 0.506, using a random-effects model for nurse-led DSME versus UC. Effect size was significantly associated with patient age older than 65 years and with duration of follow-up. Nurse-led DSME was also associated with improvements in cardiovascular risk factors, particularly among male patients, among those with good glycemic control, and in studies conducted in the United States.
Conclusions
Nurse-led DSME is associated with improved glycemic control, demonstrating that programs are most effective among seniors and with follow-up periods of 1 to 6 months. Future programs tailored to the needs of patients younger than 65 years may improve the impact of DSME on blood glucose. |
| doi_str_mv | 10.1177/0145721711423978 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_921425341</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0145721711423978</sage_id><sourcerecordid>1011214493</sourcerecordid><originalsourceid>FETCH-LOGICAL-c355t-c3ce4f65f16c30d42a9f15dd693bcebdc5c8833ec934bfc40b1470c6e7b042293</originalsourceid><addsrcrecordid>eNqFkc1v1DAQxS0Eokvhzgn5BpcUjz_i-IiWbYtUgQTlHDn2uKQ4cbETpP3v8WoLB6SCNJo5zO-9w3uEvAR2BqD1WwZSaQ4aQHJhdPeIbEAp2bSsFY_J5vBuDv8T8qyUW8aEkqZ7Sk44B2ilFhuyXn9DugsB3UJToB_XXLCJ6On70Q64YKFfMIZmsrO9wQnnhe786uwyppnWuYh7l8o-2qVKLnFKNzEN40zt7OnWZj-mn7a4NdpMP4_lOz23bkm5PCdPgo0FX9zfU_L1fHe9vWyuPl182L67apxQaqnboQytCtA6wbzk1gRQ3rdGDA4H75TrOiHQGSGH4CQbQGrmWtQDk5wbcUpeH33vcvqxYln6aSwOY7QzprX0htfglJBQyTf_JIG3HeuYAf1_lAFUX2lERdkRdTmVkjH0d3mcbN5XqD802P_dYJW8undfhwn9H8HvyirQHIFSG-lv05rnGuHDhr8AKRui0w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1011214493</pqid></control><display><type>article</type><title>The Effect of Nurse-led Diabetes Self-management Education on Glycosylated Hemoglobin and Cardiovascular Risk Factors: A Meta-analysis</title><source>MEDLINE</source><source>SAGE Journals</source><source>Alma/SFX Local Collection</source><creator>Tshiananga, Jacques Kande Tshiang ; Kocher, Serge ; Weber, Christian ; Erny-Albrecht, Katrina ; Berndt, Karsten ; Neeser, Kurt</creator><creatorcontrib>Tshiananga, Jacques Kande Tshiang ; Kocher, Serge ; Weber, Christian ; Erny-Albrecht, Katrina ; Berndt, Karsten ; Neeser, Kurt</creatorcontrib><description>Purpose
The purpose of this meta-analysis was to determine the effect of nurse-led diabetes self-management education (DSME) on blood glucose control and cardiovascular risk factors.
Methods
The electronic databases PubMed and ISIS Knowledge were searched for relevant randomized controlled studies published between 1999 and 2009. Effect size was calculated for change in A1C, blood pressure, and lipid levels using both fixed- and random-effects models. Subgroup analyses were performed on patient age, gender, diabetes type, baseline A1C, length of follow-up, and study setting.
Results
A total of 34 randomized controlled trials with a combined cohort size of 5993 patients was identified. Mean patient age was 52.8 years, 47% were male, and mean A1C at baseline was 8.5%. Mean change in A1C was a reduction by −0.70% for nurse-led DSME versus −0.21% with usual care (UC). This corresponded to an effect size of 0.506, using a random-effects model for nurse-led DSME versus UC. Effect size was significantly associated with patient age older than 65 years and with duration of follow-up. Nurse-led DSME was also associated with improvements in cardiovascular risk factors, particularly among male patients, among those with good glycemic control, and in studies conducted in the United States.
Conclusions
Nurse-led DSME is associated with improved glycemic control, demonstrating that programs are most effective among seniors and with follow-up periods of 1 to 6 months. Future programs tailored to the needs of patients younger than 65 years may improve the impact of DSME on blood glucose.</description><identifier>ISSN: 0145-7217</identifier><identifier>EISSN: 1554-6063</identifier><identifier>DOI: 10.1177/0145721711423978</identifier><identifier>PMID: 22116473</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Age ; Biomarkers - blood ; Blood pressure ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - prevention & control ; Clinical trials ; Diabetes mellitus ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 1 - nursing ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - nursing ; Diabetic Angiopathies - blood ; Diabetic Angiopathies - epidemiology ; Diabetic Angiopathies - prevention & control ; Disease Management ; Education ; Female ; Gender ; Glucose ; Glycated Hemoglobin A - metabolism ; Humans ; Lipids ; Male ; Middle Aged ; Nurse Clinicians ; Nursing ; Patient Education as Topic ; Risk factors ; Self Care</subject><ispartof>The Diabetes educator, 2012-01, Vol.38 (1), p.108-123</ispartof><rights>2012 American Association of Diabetes Educators; Published by SAGE Publications</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c355t-c3ce4f65f16c30d42a9f15dd693bcebdc5c8833ec934bfc40b1470c6e7b042293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0145721711423978$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0145721711423978$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21817,27922,27923,43619,43620</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22116473$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tshiananga, Jacques Kande Tshiang</creatorcontrib><creatorcontrib>Kocher, Serge</creatorcontrib><creatorcontrib>Weber, Christian</creatorcontrib><creatorcontrib>Erny-Albrecht, Katrina</creatorcontrib><creatorcontrib>Berndt, Karsten</creatorcontrib><creatorcontrib>Neeser, Kurt</creatorcontrib><title>The Effect of Nurse-led Diabetes Self-management Education on Glycosylated Hemoglobin and Cardiovascular Risk Factors: A Meta-analysis</title><title>The Diabetes educator</title><addtitle>Diabetes Educ</addtitle><description>Purpose
The purpose of this meta-analysis was to determine the effect of nurse-led diabetes self-management education (DSME) on blood glucose control and cardiovascular risk factors.
Methods
The electronic databases PubMed and ISIS Knowledge were searched for relevant randomized controlled studies published between 1999 and 2009. Effect size was calculated for change in A1C, blood pressure, and lipid levels using both fixed- and random-effects models. Subgroup analyses were performed on patient age, gender, diabetes type, baseline A1C, length of follow-up, and study setting.
Results
A total of 34 randomized controlled trials with a combined cohort size of 5993 patients was identified. Mean patient age was 52.8 years, 47% were male, and mean A1C at baseline was 8.5%. Mean change in A1C was a reduction by −0.70% for nurse-led DSME versus −0.21% with usual care (UC). This corresponded to an effect size of 0.506, using a random-effects model for nurse-led DSME versus UC. Effect size was significantly associated with patient age older than 65 years and with duration of follow-up. Nurse-led DSME was also associated with improvements in cardiovascular risk factors, particularly among male patients, among those with good glycemic control, and in studies conducted in the United States.
Conclusions
Nurse-led DSME is associated with improved glycemic control, demonstrating that programs are most effective among seniors and with follow-up periods of 1 to 6 months. Future programs tailored to the needs of patients younger than 65 years may improve the impact of DSME on blood glucose.</description><subject>Age</subject><subject>Biomarkers - blood</subject><subject>Blood pressure</subject><subject>Cardiovascular Diseases - blood</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Clinical trials</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - nursing</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - nursing</subject><subject>Diabetic Angiopathies - blood</subject><subject>Diabetic Angiopathies - epidemiology</subject><subject>Diabetic Angiopathies - prevention & control</subject><subject>Disease Management</subject><subject>Education</subject><subject>Female</subject><subject>Gender</subject><subject>Glucose</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Lipids</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nurse Clinicians</subject><subject>Nursing</subject><subject>Patient Education as Topic</subject><subject>Risk factors</subject><subject>Self Care</subject><issn>0145-7217</issn><issn>1554-6063</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1v1DAQxS0Eokvhzgn5BpcUjz_i-IiWbYtUgQTlHDn2uKQ4cbETpP3v8WoLB6SCNJo5zO-9w3uEvAR2BqD1WwZSaQ4aQHJhdPeIbEAp2bSsFY_J5vBuDv8T8qyUW8aEkqZ7Sk44B2ilFhuyXn9DugsB3UJToB_XXLCJ6On70Q64YKFfMIZmsrO9wQnnhe786uwyppnWuYh7l8o-2qVKLnFKNzEN40zt7OnWZj-mn7a4NdpMP4_lOz23bkm5PCdPgo0FX9zfU_L1fHe9vWyuPl182L67apxQaqnboQytCtA6wbzk1gRQ3rdGDA4H75TrOiHQGSGH4CQbQGrmWtQDk5wbcUpeH33vcvqxYln6aSwOY7QzprX0htfglJBQyTf_JIG3HeuYAf1_lAFUX2lERdkRdTmVkjH0d3mcbN5XqD802P_dYJW8undfhwn9H8HvyirQHIFSG-lv05rnGuHDhr8AKRui0w</recordid><startdate>20120101</startdate><enddate>20120101</enddate><creator>Tshiananga, Jacques Kande Tshiang</creator><creator>Kocher, Serge</creator><creator>Weber, Christian</creator><creator>Erny-Albrecht, Katrina</creator><creator>Berndt, Karsten</creator><creator>Neeser, Kurt</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>7X8</scope></search><sort><creationdate>20120101</creationdate><title>The Effect of Nurse-led Diabetes Self-management Education on Glycosylated Hemoglobin and Cardiovascular Risk Factors</title><author>Tshiananga, Jacques Kande Tshiang ; Kocher, Serge ; Weber, Christian ; Erny-Albrecht, Katrina ; Berndt, Karsten ; Neeser, Kurt</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c355t-c3ce4f65f16c30d42a9f15dd693bcebdc5c8833ec934bfc40b1470c6e7b042293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age</topic><topic>Biomarkers - blood</topic><topic>Blood pressure</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Clinical trials</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Diabetes Mellitus, Type 1 - nursing</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - nursing</topic><topic>Diabetic Angiopathies - blood</topic><topic>Diabetic Angiopathies - epidemiology</topic><topic>Diabetic Angiopathies - prevention & control</topic><topic>Disease Management</topic><topic>Education</topic><topic>Female</topic><topic>Gender</topic><topic>Glucose</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Lipids</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nurse Clinicians</topic><topic>Nursing</topic><topic>Patient Education as Topic</topic><topic>Risk factors</topic><topic>Self Care</topic><toplevel>online_resources</toplevel><creatorcontrib>Tshiananga, Jacques Kande Tshiang</creatorcontrib><creatorcontrib>Kocher, Serge</creatorcontrib><creatorcontrib>Weber, Christian</creatorcontrib><creatorcontrib>Erny-Albrecht, Katrina</creatorcontrib><creatorcontrib>Berndt, Karsten</creatorcontrib><creatorcontrib>Neeser, Kurt</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>MEDLINE - Academic</collection><jtitle>The Diabetes educator</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tshiananga, Jacques Kande Tshiang</au><au>Kocher, Serge</au><au>Weber, Christian</au><au>Erny-Albrecht, Katrina</au><au>Berndt, Karsten</au><au>Neeser, Kurt</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Nurse-led Diabetes Self-management Education on Glycosylated Hemoglobin and Cardiovascular Risk Factors: A Meta-analysis</atitle><jtitle>The Diabetes educator</jtitle><addtitle>Diabetes Educ</addtitle><date>2012-01-01</date><risdate>2012</risdate><volume>38</volume><issue>1</issue><spage>108</spage><epage>123</epage><pages>108-123</pages><issn>0145-7217</issn><eissn>1554-6063</eissn><abstract>Purpose
The purpose of this meta-analysis was to determine the effect of nurse-led diabetes self-management education (DSME) on blood glucose control and cardiovascular risk factors.
Methods
The electronic databases PubMed and ISIS Knowledge were searched for relevant randomized controlled studies published between 1999 and 2009. Effect size was calculated for change in A1C, blood pressure, and lipid levels using both fixed- and random-effects models. Subgroup analyses were performed on patient age, gender, diabetes type, baseline A1C, length of follow-up, and study setting.
Results
A total of 34 randomized controlled trials with a combined cohort size of 5993 patients was identified. Mean patient age was 52.8 years, 47% were male, and mean A1C at baseline was 8.5%. Mean change in A1C was a reduction by −0.70% for nurse-led DSME versus −0.21% with usual care (UC). This corresponded to an effect size of 0.506, using a random-effects model for nurse-led DSME versus UC. Effect size was significantly associated with patient age older than 65 years and with duration of follow-up. Nurse-led DSME was also associated with improvements in cardiovascular risk factors, particularly among male patients, among those with good glycemic control, and in studies conducted in the United States.
Conclusions
Nurse-led DSME is associated with improved glycemic control, demonstrating that programs are most effective among seniors and with follow-up periods of 1 to 6 months. Future programs tailored to the needs of patients younger than 65 years may improve the impact of DSME on blood glucose.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>22116473</pmid><doi>10.1177/0145721711423978</doi><tpages>16</tpages></addata></record> |
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| ispartof | The Diabetes educator, 2012-01, Vol.38 (1), p.108-123 |
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| subjects | Age Biomarkers - blood Blood pressure Cardiovascular Diseases - blood Cardiovascular Diseases - epidemiology Cardiovascular Diseases - prevention & control Clinical trials Diabetes mellitus Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - nursing Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - nursing Diabetic Angiopathies - blood Diabetic Angiopathies - epidemiology Diabetic Angiopathies - prevention & control Disease Management Education Female Gender Glucose Glycated Hemoglobin A - metabolism Humans Lipids Male Middle Aged Nurse Clinicians Nursing Patient Education as Topic Risk factors Self Care |
| title | The Effect of Nurse-led Diabetes Self-management Education on Glycosylated Hemoglobin and Cardiovascular Risk Factors: A Meta-analysis |
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