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The effect of a diabetes education programme (PRIMAS) for people with type 1 diabetes: Results of a randomized trial
Abstract
Objective In a randomized, multi-centre trial, the efficacy of a self-management-oriented education programme (PRIMAS) for people with type 1 diabetes was compared with an established education programme as control group (CG). Primary outcome was the effect on glycaemic control in a 6-month follow-up. Secondary outcomes were the impact on emotional aspects, self-management related aspects and hypoglycaemia problems. Methods The study was conducted in an outpatient setting. 160 participants were randomized. Baseline characteristics in PRIMAS and CG were similar (age 45.1±13.5 vs. 45.9±13.1 years, p=.716; diabetes duration 18.8±12.3 vs. 19.8±13.4 years, p=.615; BMI 26.5±4.6 vs. 27.5±5.0kg/m(2), p=.236; HbA1c 8.3±1.1 vs. 8.1±1.0%, p=.236). Results At follow-up there was a significant 0.4 percentage points greater reduction of HbA1c in PRIMAS compared to CG (Δ -0.4±1.0% vs. Δ 0.0±0.6%; p=.012). Also, diabetes-related distress (Δ -0.3±0.7 vs. -0.1±0.4, p=.032) and dissatisfaction with diabetes treatment (Δ -3.3±6.9 vs. -1.9±5.6, p=.024) decreased more in PRIMAS. Diabetes empowerment (Δ 2.6±5.9 vs. 0.8±5.1, p=.037) and diabetes self-efficacy (Δ 1.4±3.6 vs. 0.2±4.0, p=.013) increased in PRIMAS. Incidence of severe hypoglycemia, hypoglycemia awareness, diabetes knowledge, and self-care behaviour improved in both groups with no significant differences between groups. Conclusion PRIMAS is more effective in lowering HbA1c than a previously established education programmes and also showed superiority in reducing diabetes-related distress and increasing diabetes empowerment, diabetes self-efficacy and satisfaction with insulin therapy.
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“Intensive insulin management education programs that include nutrition therapy have been shown to improve A1C (9,264,268,271 -273) and quality of life (9,274).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [273]
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Metadata
- Authors
- Hermanns, N., Kulzer, B., Ehrmann, D., Bergis-Jurgan, N., & Haak, T.
- Affiliations
- German Diabetes Center Mergentheim (DE)
- Forschungsinstitut der Diabetes Akademie Mergentheim (DE)
- Corresponding author
- Hermanns, Norbert
- Venue
- Diabetes Research and Clinical Practice
- Publisher
- Elsevier BV
- Published
- 2013-12
- Volume
- 102
- Issue
- 3
- Pages
- 149-157
- ISSN
- 0168-8227 (ISSN-L)
- OpenAlex
- W2052670832
- Cited by
- 105
- References
- 28
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 4 · 2023: 4 · 2022: 8 · 2021: 2 · 2020: 14 · 2019: 12 · 2018: 6 · 2017: 11 · 2016: 9 · 2015: 12 · 2014: 3
- FWCI
- 6.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Research and Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- diabetes education, glycemic control, HbA1c, diabetes distress, diabetes empowerment, diabetes self-efficacy, hypoglycemia, hypoglycemia awareness, diabetes knowledge, self-care behavior
- MeSH terms
- Adult, Aged, Awareness, Blood Glucose, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Germany, Humans, Hypoglycemia, Insulin, Male, Middle Aged, Patient Education as Topic, Power, Psychological, Prospective Studies, Self Care, Incidence, Case-Control Studies, Young Adult
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