Weekly phone advice helps diabetics cope
By Joene Hendry
NEW YORK (Reuters Health) - Among low-income men and women with diabetes, those who participated in weekly, automated telephone-prompt sessions saw their skills in managing their condition improve, researchers report.
Compared with those who attended monthly diabetes-care group sessions or received usual care, individuals who received and responded to weekly diabetes self-management telephone prompts reported fewer days bed-ridden and fewer disease-related restrictions in daily activities a year later, according to Dr. Dean Schillinger, of the University of California, San Francisco, and colleagues.
Even so, neither telephone nor group self-management sessions improved blood sugar levels over usual care, Schillinger's team reports in the journal Diabetes Care.
The researchers compared how telephone and group diabetes self-management strategies, versus usual care, improved medication adherence, diet, physical activity, blood sugar monitoring, and eye and foot care, among 339 ethnically-diverse, low-income individuals with poorly controlled diabetes for more than 9 years.
The study population was about 56 years old and 59 percent female.
The investigators randomly assigned a third of the patients to answer native-language telephone-prompts each week for 9 months. These prompts triggered individualized nurse-delivered follow-up as needed.
Another third of the study group attended monthly diabetes self-management group sessions for 9 months, while the remaining third received usual care.
Compared with the usual care group, both telephone and group-session participants showed significant improvements in diabetes self-management skills when assessed a year after study enrollment.
However, Schillinger's team noted the telephone-prompt group had greater physical activity gains and better foot care, in addition to the above-noted quality of life improvements.
Schillinger commented to Reuters Health that this "simple, home-grown communication technology application could help vulnerable patients with diabetes significantly improve their health behaviors and reduce the burden that diabetes places on their lives."
SOURCE: Diabetes Care, April 2009
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