Higher education level helps diabetes self-management
MedWire News: A brief education intervention delivered by telephone is more effective at lowering glycated hemoglobin (HbA1c) levels in individuals with a higher rather than lower educational attainment, US researchers report.
Type 2 diabetes patients with a less formal education may require more intensive diabetes self-management interventions while those with a more formal education may be effectively treated by brief, less intensive interventions, they suggest.
"Although brief diabetes interventions show promise on average, it is important to determine whether patients with lower educational attainment are also benefitting," writes the team.
To investigate, William Sacco (University of South Florida) and colleagues analyzed information available for 62 participants from a previous study investigating the effect of a brief, regular telephone intervention by paraprofessionals in Type 2 diabetes.
The participants were randomly assigned to receive either usual care and intervention or just usual care (control group). The intervention involved delivery of a brief (15-20 minutes) lifestyle modification program over the telephone on a weekly basis for 3 months then biweekly for a further 3 months.
Telephone sessions were structured to address the main areas of diabetes self-care including blood sugar testing, medication management, diet/nutrition, exercise/physical activity, foot care, and stress management.
The participants' HbA1c levels were measured before and after the intervention.
Educational attainment was measured by a single question asking about the "level of school completed".
As reported in the journal Diabetes Research and Clinical Practice, in less educated participants (maximum education was vocational/technical school), the coaching intervention was associated with a 0.6% increase in HbA1c levels compared with less educated participants in the control group.
In contrast, in participants with above median education (minimum of 1-3 years college) the coaching intervention was associated with a 0.7% decrease in HbA1c, compared with those in the control condition.
"Our results suggest that brief diabetes interventions may be more effective for people with greater educational attainment," write Sacco et al.
"Clinicians and researchers should consider our finding in light of the increased emphasis on brief healthcare interventions and the fact that chronic health problems are more common among less educated persons," they conclude.
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By Sally Robertson