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Effect of health literacy and exercise-focused interventions on glycemic control in patients with type 2 diabetes in China / 中华流行病学杂志
Chinese Journal of Epidemiology ; (12): 357-362, 2018.
Article in Zh | WPRIM | ID: wpr-736494
Responsible library: WPRO
ABSTRACT
Objective To evaluate the effect of health literacy and exercise-focused interventions on glycemic control in patients with type 2 diabetes (T2DM) in China.Methods In this cluster randomized controlled trial,a total of 799 T2DM patients with most recent hemoglobin Alc (HbAlc) ≥ 7.5% (or fasting plasma glucose level ≥ 10 mmol/L) were recruited from 8 communities in Minhang and Changning districts of Shanghai,and randomized into a health literacy intervention group,an exercise intervention group,a comprehensive intervention group and a control group.After baseline survey and examination,a one-year intervention and 3 times (at 3rd,6th,and 12th month) follow-up surveys were conducted.Results The follow-up rates for all the subjects were 99.4%,98.4% and 95.2%,respectively,at 3rd,6th and 12th month.Patients in intervention groups were more likely to achieve a goal HbAlc level (HbA1c < 7.0%) than those in control group,with the highest glycemic control rate (25.3%) observed in comprehensive intervention group at 3rd month and then in exercise intervention group (25.3% and 34.6%) respectively,at 6th month and 12th month.The average levels of HbAlc in three intervention groups were lower at each follow-up time point than those at baseline survey.However,the decreases in HbA1c were obvious only at 6th month (P<0.001),with ls-mean (95%CI) of-0.48% (-0.71%,-0.25%),-0.33% (-0.55%,-0.11%) and-0.70% (-0.92%,-0.48%),respectively,in comprehensive,health literacy and exercise intervention groups,but it increased slightly by 0.03% (-0.19%,0.25%) in control group.Compared with control group,the interventions were significantly associated with the decrease of HbA1c level,with the most improvement observed in comprehensive group (3 =-0.47,95% CI-0.73,-0.20) at 3rd month,and in exercise intervention group at 6th month (3=-0.73,95%CI-0.98,-0.47) and at 12th month (β=-0.75,95%CI-1.05,-0.45) of follow-up.Stratified analyses showed that patients with lower health literacy level could benefit from any intervention,while those with higher numeracy skill benefited more from exercise intervention.Conclusion Both health literacy and exercise-focused interventions may decrease HbA1c level in patients with T2DM,which would be helpful in reducing the risks of complications and deaths in diabetes patients.
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Full text: 1 Index: WPRIM Type of study: Clinical_trials Language: Zh Journal: Chinese Journal of Epidemiology Year: 2018 Type: Article
Full text: 1 Index: WPRIM Type of study: Clinical_trials Language: Zh Journal: Chinese Journal of Epidemiology Year: 2018 Type: Article