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Structured peer-led diabetes self-management and support in a low-income country: The ST2EP randomised controlled trial in Mali
- Source :
- PLoS ONE, PLoS ONE, Public Library of Science, 2018, 13 (1), pp.e0191262. ⟨10.1371/journal.pone.0191262⟩, PLoS ONE, Vol 13, Iss 1, p e0191262 (2018), PLoS ONE, 2018, 13 (1), pp.e0191262. ⟨10.1371/journal.pone.0191262⟩
- Publication Year :
- 2018
- Publisher :
- HAL CCSD, 2018.
-
Abstract
- Objectives Our objective was to evaluate the effectiveness of peer-led self-management education in improving glycaemic control in patients with type 2 diabetes in a low-income country (Mali). Methods We conducted an open-label randomised controlled trial. A total of 151 adults (76% women, mean age 52.5) with type 2 diabetes (HbA1c≥8%), treated in the diabetes consultation units of two secondary health centres in Bamako, were allocated to peer-led structured patient education (n = 76) or conventional care alone (n = 75). The intervention group received 1 year of culturally tailored structured patient education (3 courses of 4 sessions) delivered in the community by five trained peer educators. Both groups underwent conventional diabetes monitoring and follow-up. Primary outcome was the mean absolute change in HbA1c from baseline to 12 months. Results 177 education sessions were delivered to the intervention group. Patient attrition was 8%. From baseline to 12 months, the decrease in HbA1c levels was 1.05% (SD = 2.0; CI95%: 1.54;-0.56) in the intervention group compared with 0.15% (SD = 1.7; CI95%: -0.56; 0.26) in the control group, p = 0.006. Mean BMI change was -1.65 kg/m2 (SD = 2.5; CI95%: -2.25; -1.06) in the intervention group and +0.05 kg/m2 (SD = 3.2; CI95%: -0.71; 0.81) in the control group, p = 0.0005. Mean waist circumference decreased by 3.34 cm (SD = 9.3; CI95%: -5.56;-1.13) in the intervention group and increased by 2.65 cm (SD = 10.3; CI95%: 0.20; 5.09) in the control group, p = 0.0003. Conclusions Peer-led structured patient education delivered over 1 year to patients with poorly controlled type 2 diabetes in Mali yielded substantial improvements in glycaemic control and anthropometric parameters. This is of importance for the scaling up of efficient interventions in low-resource settings in the future. Trial registration ClinicalTrials.gov NCT01485913
- Subjects :
- Male
Psychological intervention
lcsh:Medicine
Social Sciences
Type 2 diabetes
Human learning
Mali
Biochemistry
Vascular Medicine
law.invention
Geographical Locations
0302 clinical medicine
Endocrinology
Learning and Memory
Diabetes mellitus
Randomized controlled trial
law
Health care
Outcome Assessment, Health Care
Medicine and Health Sciences
Diabetes diagnosis and management
Psychology
030212 general & internal medicine
lcsh:Science
2. Zero hunger
Multidisciplinary
Middle Aged
3. Good health
Health education and awareness
Blood pressure
Female
Research Article
Adult
medicine.medical_specialty
Waist
HbA1c
Patients
Endocrine Disorders
030209 endocrinology & metabolism
Peer Group
03 medical and health sciences
Patient Education as Topic
medicine
Learning
Humans
Hemoglobin
Developing Countries
Glycated Hemoglobin
Biology and life sciences
business.industry
Self-Management
lcsh:R
Cognitive Psychology
Proteins
Peer group
medicine.disease
Diagnostic medicine
Health Care
Self Care
Diabetes Mellitus, Type 2
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Metabolic Disorders
People and Places
Africa
Physical therapy
Cognitive Science
lcsh:Q
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
Patient education
Neuroscience
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Database :
- OpenAIRE
- Journal :
- PLoS ONE, PLoS ONE, Public Library of Science, 2018, 13 (1), pp.e0191262. ⟨10.1371/journal.pone.0191262⟩, PLoS ONE, Vol 13, Iss 1, p e0191262 (2018), PLoS ONE, 2018, 13 (1), pp.e0191262. ⟨10.1371/journal.pone.0191262⟩
- Accession number :
- edsair.doi.dedup.....e7c5278bafae79a4c139ceae7f1585f2