Mejora en el control de los diabéticos tipo 2 tras una intervención conjunta: educación diabetológica y ejercicio físico / Improvement of control in subjects with type 2 diabetes after a joint intervention: diabetes education and physical activity

ObjetivoConocer la mejora del control (metabólico, factores de riesgo cardiovascular), adherencia, autocontrol, autocuidados y actitudes/motivaciones de los diabéticos tipo 2 (DM2) de una zona de salud, tras intervención comunitaria grupal: educación diabetológica (ED) y ejercicio físico (EF).DiseñoEnsayo clínico aleatorizado controlado, simple ciego. Intervención: Grupo 1: ED grupal, Grupo 2: ED grupal y ejercicio físico, Grupo 3: solo ejercicio y Grupo 4 “control”: atención individual en consulta.EmplazamientoZona salud urbana (centro de salud/pabellón deportivo).Participantes108 DM2, 40-70 años, hemoglobina glucosilada (HbA1c) ≤ 8,5%, tensión arterial (TA)<160/90 e índice de masa corporal (IMC)<45, excluyéndose aquellos con complicaciones crónicas y/o descompensación aguda.IntervencionesDurante 6 meses, se realizaron 8 talleres de educación grupal y ejercicio físico monitorizado de intensidad moderada, 3 horas/semana.Mediciones principalesPre y post-intervención variable principal: descenso de HbA1c; demás variables: datos exploratorios, analíticos, cumplimiento terapéutico, autocontrol, autocuidados, actitudes y motivaciones (encuesta DAS-3sp).ResultadosTras intervenciones, más diabéticos bajaban HbA1c con intervención plena “ED y EF”, RR: 1,93 (0,85-4,40), así como con ejercicio, RR: 1,56 (0,65-3,76). Con ED y EF simultáneo, más sujetos descendieron IMC, RR: 1,61 (0,85-3,03) y LDL-colesterol, RR: 1,82 (0,99-3,36), aumentando cumplimiento dietético, RR: 1,29 (0,32-5,22) y de ejercicio, RR: 1,93 (0,76-4,91), realizando más autocontroles/semana, RR: 3,86 (0,90-16,55) y mejorando motivaciones/actitudes en “valoración del control estricto”, RR: 1,48 (0,94-2,34). Con ejercicio aislado la TA sistólica y diastólica descendió en más pacientes, RR: 1,35 (0,72-2,52), 1,87 (0,72-4,84), mientras que con ED grupal solo la diastólica, RR: 1,80 (0,69-4,67)(AU)

ConclusionesLos pacientes mejoran más con la combinación de ED y EF, aunque los resultados no sean estadísticamente significativos, probablemente por insuficiente tamaño muestral(AU)

ObjectiveTo study the improvement of metabolic control and cardiovascular risk factors, adherence, self-monitoring, self-care, attitudes and motivation in subjects with Type 2 Diabetes (DM2) in a specific Health Care Area after group intervention through the community: diabetes education (DE) and physical exercise (PE).DesignA single blind, randomised controlled clinical trial. Intervention: group 1: DE; group 2: ED and PE; group 3: only PE, and “control” group-4: Individual consultations.LocationUrban health centre/municipal sports centre.Participants108 DM2, age: 40-70, glycated haemoglobin (HbA1c) ≤ 8.5%, blood pressure (BP)<160/90 and body mass index (BMI)<45, excluding those with chronic complications and/or acute decompensation.InterventionsDuring 6 months, 8 workshops were held for group education and monitored aerobic physical exercise of moderate intensity (3hours a week).Main measurementsPrimary variable pre- and post- intervention: reduction in HbA1c; other variables: examination and analytical data, therapeutic compliance, self-monitoring, self-care, attitudes and motivation (DAS-3SP survey).ResultsAfter intervention, more diabetics had a lower HbA1c following a full intervention: “DE” and “PE”, RR: 1.93 (0.85-4.40) and exercise, RR: 1.56 (0.65-3.76). With simultaneous DE and PE, the BMI, RR: 1.61 (0.85-3.03) and LDL cholesterol, RR: 1.82 (0.99-3.36), of many subjects decreased. Dietary compliance, RR: 1.29 (0.32-5.22) and exercise, RR: 1.93 (0.76-4.91) also increased, more patients performing their own checks, RR: 3.86 (0.90-16.55) and improving motivation/attitudes in “strict control management”, RR: 1.48 (0.94-2.34). With PE, systolic and diastolic BP decreased in more patients RR: 1.35 (0.72-2.52), 1.87 (0.72-4.84) while in the DE group only diastolic values decreased 1.80 (0.69-4.67)(AU)

ConclusionsPatient conditions improve more with the combination of DE and PE, though the results are not statistically significant, probably due to insufficient sample size(AU)

[Improvement of control in subjects with type 2 diabetes after a joint intervention: diabetes education and physical activity]. / Mejora en el control de los diabéticos tipo 2 tras una intervención conjunta: educación diabetológica y ejercicio físico.

OBJECTIVE: To study the improvement of metabolic control and cardiovascular risk factors, adherence, self-monitoring, self-care, attitudes and motivation in subjects with Type 2 Diabetes (DM2) in a specific Health Care Area after group intervention through the community: diabetes education (DE) and physical exercise (PE). DESIGN: A single blind, randomised controlled clinical trial. INTERVENTION: group 1: DE; group 2: ED and PE; group 3: only PE, and "control" group-4: Individual consultations. LOCATION: Urban health centre/municipal sports centre. PARTICIPANTS: 108 DM2, age: 40-70, glycated haemoglobin (HbA(1)c) ≤ 8.5%, blood pressure (BP)<160/90 and body mass index (BMI)<45, excluding those with chronic complications and/or acute decompensation. INTERVENTIONS: During 6 months, 8 workshops were held for group education and monitored aerobic physical exercise of moderate intensity (3 hours a week). MAIN MEASUREMENTS: Primary variable pre- and post- intervention: reduction in HbA(1)c; other variables: examination and analytical data, therapeutic compliance, self-monitoring, self-care, attitudes and motivation (DAS-3SP survey). RESULTS: After intervention, more diabetics had a lower HbA(1)c following a full intervention: "DE" and "PE", RR: 1.93 (0.85-4.40) and exercise, RR: 1.56 (0.65-3.76). With simultaneous DE and PE, the BMI, RR: 1.61 (0.85-3.03) and LDL cholesterol, RR: 1.82 (0.99-3.36), of many subjects decreased. Dietary compliance, RR: 1.29 (0.32-5.22) and exercise, RR: 1.93 (0.76-4.91) also increased, more patients performing their own checks, RR: 3.86 (0.90-16.55) and improving motivation/attitudes in "strict control management", RR: 1.48 (0.94-2.34). With PE, systolic and diastolic BP decreased in more patients RR: 1.35 (0.72-2.52), 1.87 (0.72-4.84) while in the DE group only diastolic values decreased 1.80 (0.69-4.67). CONCLUSIONS: Patient conditions improve more with the combination of DE and PE, though the results are not statistically significant, probably due to insufficient sample size.