E. Borgo

Lifestyle intervention by group care prevents deterioration of Type II diabetes: a 4-year randomized controlled clinical trial.

AbstractAims/hypothesis. Metabolic control worsens progressively in Type II (non-insulin-dependent) diabetes mellitus despite intensified pharmacological treatment and lifestyle intervention, when these are implemented on a one-to-one basis. We compared traditional individual diabetes care with a model in which routine follow-up is managed by interactive group visits while individual consultations are reserved for emerging medical problems and yearly checks for complications.n Methods. A randomized controlled clinical trial of 56 patients with non-insulin-treated Type II diabetes managed by systemic group education and 56 control patients managed by individual consultations and education.n Results. Observation times were 51.2±2.1 months for group care and 51.2±1.8 for control subjects. Glycated haemoglobin increased in the control group but not in the group of patients (p<0.001), in whom BMI decreased (p<0.001) and HDL-cholesterol increased (p<0.001). Quality of life, knowledge of diabetes and health behaviours improved with group care (p<0.001, all) and worsened among the control patients (p=0.004 to p<0.001). Dosage of hypoglycaemic agents decreased (p<0.001) and retinopathy progressed less (p<0.009) among the group care patients than the control subjects. Diastolic blood pressure (p<0.001) and relative cardiovascular risk (p<0.05) decreased from baseline in group patients and control patients alike. Over the study period, group care required 196xa0min and 756.54xa0USxa0

Sleep abnormalities in type 2 diabetes may be associated with glycemic control

per patient, compared with 150xa0min and 665.77xa0USxa0

The locus of control in patients with Type 1 and Type 2 diabetes managed by individual and group care

for the control patients, resulting in an additional 2.12xa0USxa0

Quality of Life, Coping Ability, and Metabolic Control in Patients With Type 1 Diabetes Managed By Group Care and a Carbohydrate Counting Program

spent per point gained in the quality of life score.n Conclusion/interpretation. Group care by systemic education is feasible in an ordinary diabetes clinic and cost-effective in preventing the deterioration of metabolic control and quality of life in Type II diabetes without increasing pharmacological treatment.

Perceptions of diabetic retinopathy and screening procedures among diabetic people

Sleep disturbances may be associated with impaired glucose metabolism. The aim of this study was to evaluate sleep duration and quality in relation to glycemic control in patients with type 2 diabetes. In a cross-sectional study, sleep duration and quality were assessed in 47 middle-aged patients with type 2 diabetes treated with oral agents and without sleep disturbing complications and 23 healthy control subjects similar by age, sex, body mass index, occupation and schooling. Sleep was recorded by wrist-actigraphy for three consecutive days under free-living conditions. Univariate analysis showed lower sleep maintenance (Pxa0=xa00.002) and sleep efficiency (Pxa0=xa00.005), and higher fragmentation index (Pxa0<xa00.0001), total activity score (Pxa0=xa00.05) and moving time (Pxa0<xa00.0001) in patients with type 2 diabetes. After adjusting for age, gender and schooling, fragmentation index and moving time remained significantly higher in the patients with diabetes (Pxa0<xa00.05, both). HbA1c correlated inversely with sleep efficiency (rxa0=xa0−0.29; Pxa0=xa00.047) and positively with moving time (rxa0=xa00.31; Pxa0=xa00.031). These findings suggest that type 2 diabetes is associated with sleep disruptions even in the absence of complications or obesity. The relevance of sleep abnormalities to metabolic control and possible strategies to improve sleep quality in type 2 diabetes deserve further investigation.

Learning, Health Behavior and Quality of Life Modifications over 5 Years in People with Type 2 Diabetes Managed by Group Care

Aimsu2003 The locus of control theory distinguishes people (internals) who attribute events in life to their own control, and those (externals) who attribute events to external circumstances. It is used to assess self‐management behaviour in chronic illnesses. Group care is a model of systemic group education that improves lifestyle behaviour and quality of life in patients with Type 1 and Type 2 diabetes. This study investigated the locus of control in Type 1 and Type 2 diabetes and the possible differences between patients managed by group care and control subjects followed by traditional one‐to‐one care.

A 5-Year Randomized Controlled Study of Learning, Problem Solving Ability, and Quality of Life Modifications in People With Type 2 Diabetes Managed by Group Care

Group care is a clinical-pedagogic model in which traditional routine visits are substituted by sessions of group education. This approach improves quality of life and metabolic control in patients with type 2 diabetes (1) but only quality of life in those with type 1 diabetes (2). The latter must match multiple daily insulin administrations with blood glucose monitoring, dietary intake, and energy expenditure (3). We hypothesized that to improve their coping strategies, patients with type 1 diabetes need more specific training in the technical aspects of day-to-day management of insulin therapy. To verify this, we studied the effects of embedding a carbohydrate counting program within group care on quality of life, knowledge …

A 3-year prospective randomized controlled clinical trial of group care in type 1 diabetes

Aims To assess how diabetic patients perceive retinopathy, screening for sight‐threatening lesions and their own role in preventing blindness.

La narrazione autobiografica e la rilettura delle esperienze personali come strumento di formazione in ambito sanitario.

This chapter describes the time-course changes of knowledge, health behavior and quality nof life in patients with type 2 diabetes managed by Group Care, as compared with individually ndelivered care