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Collaboration with community program improved diabetes self-management
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AADE Annual Meeting and Exhibition
LAS VEGAS — Partnering with a local YMCA provided an effective avenue for diabetes prevention, researchers found.
Jane Fitch Meszaros, RN, BSN, CDE, of St. Vincent Healthcare in Billings, Mont., said the success of the Diabetes Prevention Program (DPP) trial in lowering the incidence of diabetes among at-risk participants inspired her and colleagues to adapt the program at multiple sites in Montana. As of 2011, 14 sites are now involved in the study.
“The objective of our DPP was to evaluate weight loss and reduce cardiometabolic risk in people who were at high risk for diabetes and cardiovascular disease,” Meszaros said during a presentation. “At the St. Vincent Program, the idea was to deliver the program through a partnership between a diabetes self-management program and the YMCA.”
Meszaros and colleagues had the same goals as the original DPP, including helping participants follow low-fat diets and exercise for at least 150 minutes per week. The ultimate goal was 7% weight loss, she said. To qualify for inclusion, participants had to have a BMI of at least 25 and one additional risk factor, such as a history of gestational diabetes; delivering a baby weighing at least 9 lbs; or prediabetes (HbA1c levels between 5.7% and 6.4%). Most importantly, participants also had to exhibit a readiness to change behaviors. The first 16 weeks — dubbed Core — involved weekly sessions, typically involving one diabetes education class and two sessions of supervised physical activity. Follow-up occurred monthly for the next 6 months.
The diabetes education team from St. Vincent Healthcare was composed of two lifestyle coaches who were registered dietitians and were trained in using the adapted DPP; a nurse certified in diabetes education; and behavioral health counselors. The YMCA team offered supervised trainers who worked with small groups of the program’s participants and a community wellness coordinator. Physicians also helped by referring at-risk patients to the program via prescription.
From 2008 to 2010, the researchers enrolled 265 participants at St. Vincent Healthcare in the study. Results showed the following:
- 83% completed Core.
- 75% exercised for at least 150 minutes per week.
- 34% achieved the 7% weight-loss goal.
- More than 60% achieved 5% weight loss.
- Systolic and diastolic blood pressure decreased.
- Fasting blood glucose declined.
- HDL levels decreased.
According to pooled data from all sites in Montana during the same time period, the 1,259 participants in the program lost a total of 18,612 lb. The mean weight loss per person was 15.5 lb. HDL levels started to increase during follow-up. Participants tended to regain some of the lost weight, but overall weight loss remained significant, according to Meszaros.
“The conclusion is that doing [diabetes self-management education with registered dietitians] with the local YMCA was very successful,” she said. “These results show that diabetes self-management education can be done in many different settings. – by Melissa Foster
For more information:
- Meszaros JF. T10b. Presented at: the American Association of Diabetes Educators Annual Meeting & Exhibition; Aug. 3-6, 2011; Las Vegas.
Disclosure: Meszaros reports no relevant financial disclosures.
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