Davis RM, Hitch AD, Salaam MM, Herman WH, Zimmer-Galler IE, Mayer-Davis EJ.
University of North Carolina, Department of Ophthalmology, Chapel Hill, NC.
AbstractObjective: To conduct a one-year randomized clinical trial to evaluate a remote comprehensive diabetes self-management education (DSME) intervention, Diabetes TeleCare, administered by a dietitian and nurse/certified diabetes educator (CDE) in the setting of a federally-qualified health (FQHC) center in rural South Carolina. Research Design and Methods: Participants were recruited from three member health centers of an FQHC and were randomized to either Diabetes TeleCare, a 12-month, 13-session curriculum delivered using telehealth strategies, or usual care. Results: Mixed linear regression model results for repeated measures showed a significant reduction in glycated hemoglobin (GHb) in the Diabetes TeleCare group from baseline to 6 months and 12 months (9.4+/-0.3, 8.38.4+/-0.3, 8.2+/-0.4), compared to usual care (8.8+/-0.3, 8.6+/-0.3, 8.6+/-0.3). LDL-cholesterol was reduced at 12 months in the Diabetes TeleCare group compared to usual care. Although not part of the original study design, GHb was reduced from baseline to 12 months and 24 months in the Diabetes TeleCare group (9.2+/-0.4, 7.4+/-0.5, 7.6+/-0.5) compared to usual care (8.7+/-0.4, 8.1+/-0.4, 8.1+/-0.5) in a post-hoc analysis of a subset of the randomized sample who completed a 24-month follow-up visit. Conclusions: Telehealth effectively created access to successfully conduct a one year remote DSME by a nurse CDE and dietitian that improved metabolic control and reduced cardiovascular risk in an ethnically diverse and rural population.
PMID: 20484125
| < Prev | Next > |
|---|
