Effects of the Diabetes Manual 1:1 structured education in primary care
Open accessAbstract
Aims To determine the effects of the Diabetes Manual on glycaemic control, diabetes‐related distress and confidence to self‐care of patients with Type 2 diabetes. Methods A cluster randomized, controlled trial of an intervention group vs. a 6‐month delayed‐intervention control group with a nested qualitative study. Participants were 48 urban general practices in the West Midlands, UK, with high population deprivation levels and 245 adults with Type 2 diabetes with a mean age of 62 years recruited pre‐randomization. The Diabetes Manual is 1:1 structured education designed for delivery by practice nurses. Measured outcomes were HbA 1c , cardiovascular risk factors, diabetes‐related distress measured by the Problem Areas in Diabetes Scale and confidence to self‐care measured by the Diabetes Management Self‐Efficacy Scale. Outcomes were assessed at baseline and 26 weeks. Results There was no significant difference in HbA 1c between the intervention group and the control group [difference −0.08%, 95% confidence interval (CI) −0.28, 0.11]. Diabetes‐related distress scores were lower in the intervention group compared with the control group (difference −4.5, 95% CI −8.1, −1.0). Confidence to self‐care Scores were 11.2 points higher (95% CI 4.4, 18.0) in the intervention group compared with the control group. The patient response rate was 18.5%. Conclusions In this population, the Diabetes Manual achieved a small improvement in patient diabetes‐related distress and confidence to self‐care over 26 weeks, without a change in glycaemic control. Further study is needed to optimize the intervention and characterize those for whom it is more clinically and psychologically effective to support its use in primary care.
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Forty-four RCTs examined the impact of interventions on disease-specific outcomes.
“Forty four RCTs examined the impact of interventions on disease specific outcomes”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [44]
Physical, mental or social functioning were measured in 25 RCTs.
“Physical, mental or social functioning were measured in 25 RCTs”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [44]
Sturt et al. reported a reduction by 4.5 points in mean PAID scores at follow-up (95% CI: −8.1, −1.0), indicating lowered diabetes-related distress after a nurse-delivered intervention compared with control (p = 0.012), though this difference was considered a small effect.
“Sturt et al. [44] reported a reduction by 4.5 points in mean PAID scores at follow-up (95% CI: −8.1, −1.0), indicating lowered diabetes-related distress after a nurse-delivered intervention compared with control (p = 0.012), however this difference was considered a small effect”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [44]
Sturt et al. showed self-efficacy scores were 11.2 points higher on the DMSE (95% CI: 4.4, 18.0) in the intervention group compared with the control group following a structured intervention delivered by practice nurses in the UK (p = 0.0014).
“Sturt et al. showed self-efficacy scores were 11.2 points higher on the DMSE (95% CI: 4.4, 18.0) in the intervention group compared with the control group following a structured intervention delivered by practice nurses in the UK (p = 0.0014)”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [44]
Changes in perceived self-efficacy were reported in 14 studies.
“Changes in perceived self-efficacy were reported in 14 studies”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [44]
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Effectiveness of Self-Management Training in Type 2 Diabetes
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Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2015.11.003 · Cited by 914 · see citing works
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“8%, n = 1) [44], Normalization Process Theory [31] and Implementation Intention Theory (1.”
BackgroundDiabetes structured self-management education programmes: a narrative review and current innovations
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Self-citationPsychological interventions for diabetes-related distress in adults with type 2 diabetes mellitus
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Self-citation
- Authors
- Sturt, J. A., Whitlock, S., Fox, C., Hearnshaw, H., Farmer, A. J., Wakelin, M., Eldridge, S., Griffiths, F., & Dale, J.
- Affiliations
- Birmingham Newman University (GB)
- Queen Mary University of London (GB)
- Corresponding author
- Sturt, J. A.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2008-06
- Volume
- 25
- Issue
- 6
- Pages
- 722-731
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W1999401692
- Cited by
- 90
- References
- 3
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 6 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 7 · 2017: 4 · 2016: 6 · 2015: 8 · 2014: 5 · 2013: 6 · 2012: 9
- FWCI
- 4.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (CSA03/003)
- Diabetes UK
- University of Warwick
- 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
- type 2 diabetes, diabetes self-management education, structured education, glycemic control, HbA1c, diabetes distress, self-care confidence, practice nurses, primary care, Problem Areas in Diabetes scale
- MeSH terms
- Aged, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Male, Manuals as Topic, Middle Aged, Patient Education as Topic, Primary Health Care, Self Care, Cluster Analysis, Patient Satisfaction
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