Effectiveness of a Self-Management Intervention in Patients With Screen- Detected Type 2 Diabetes

OBJECTIVE — To examine the effectiveness of a theory-driven self-management course in reducing cardiovascular risk in patients with screen-detected type 2 diabetes, taking ongoing medical treatment into account. RESEARCH DESIGN AND METHODS — A total of 196 screen-detected patients, receiving either intensive pharmacological or usual-care treatment since diagnosis (3–33 months previously), were subsequently randomized to a control or intervention condition (self-management course). A 2 2 factorial design evaluated the behavioral intervention (self-management course versus control) nested within the medical treatment (intensive versus usual care), using multilevel regression modeling to analyze changes in patients ’ BMI, A1C, blood pressure (BP), and lipid profiles over 12 months, from the start of the 3-month course to 9-month follow-up. RESULTS — The self-management course significantly reduced BMI (0.77 kg/m2) and sys-tolic BP (6.2 mmHg) up until the 9-month follow-up, regardless of medical treatment. How-ever, intensive medical treatment was also independently associated with lower BP, A1C, total cholesterol, and LDL before the course and further improvements in systolic BP (4.7 mmHg)