A nurse-led education and cognitive behaviour therapy-based intervention among adults with uncontrolled type 2 diabetes: A randomised controlled trial
Abstract
Abstract Rationale, aims and objectives Diabetes mellitus is associated with significant morbidity, mortality, and escalating health care costs. Research has consistently demonstrated the importance of glycaemic control in delaying the onset, and decreasing the incidence, of both the short‐term and long‐term complications of diabetes. Although glycaemic control is difficult to achieve and challenging to maintain, it is key to reducing negative disease outcomes. The aim of this study was to determine whether a nurse‐led educational intervention alone or a nurse‐led intervention using education and acceptance and commitment therapy (ACT) was effective in reducing hemoglobin A 1c (HbA 1c ) in people living with uncontrolled type 2 diabetes compared to usual care. Methods Adults over the age of 18 years, with a confirmed diagnosis of type 2 diabetes and HbA 1c outside of the recommended range (4%‐7%, 20‐53 mmol/mol) for 12 months or more, were eligible to participate. Participants were randomised to either a nurse‐led education intervention, a nurse‐led education plus ACT intervention, or a usual care. One hundred and eighteen participants completed baseline data collection (N = 34 education group, N = 39 education plus ACT, N = 45 control group). An intention to treat analysis was used. Results A statistically significant reduction in HbA 1c in the education intervention group was found ( P = .011 [7.48, 8.14]). At 6 months, HbA 1c was reduced in both intervention groups (education group −0.21 and education and ACT group −0.04) and increased in the control group (+0.32). A positive change in HbA 1c (HbA 1c reduced) was noted in 50 participants overall. Twice as many participants in the intervention groups demonstrated an improvement as compared to the control group (56% of the education group, 51% education plus ACT, and 24% control group. Conclusions At 6 months post intervention, HbA 1c was reduced in both intervention groups with a greater reduction noted in the nurse‐led education intervention.
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Previous studies in type 2 diabetes have found that the HbA1c level could be reduced using ACT.
“Previous studies in type 2 diabetes have found that the HbA1c level could be reduced using ACT.17 43”
From Acceptance and commitment therapy (ACT) for adult type 1 diabetes management: Study protocol for a randomised controlled trial (2018) · cites this paper as [43]
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- Authors
- Whitehead, L. C., Crowe, M. T., Carter, J. D., Maskill, V. R., Carlyle, D., Bugge, C., & Frampton, C. M. A.
- Affiliations
- Edith Cowan University (AU)
- University of Otago (NZ)
- University of Canterbury (NZ)
- University of Stirling (GB)
- Corresponding author
- Whitehead, Lisa C.
- ORCID
- Venue
- Journal of Evaluation in Clinical Practice
- Publisher
- Wiley
- Published
- 2017-04-11
- Volume
- 23
- Issue
- 4
- Pages
- 821-829
- ISSN
- 1356-1294 (ISSN-L)
- 1365-2753
- OpenAlex
- W2607475310
- Cited by
- 52
- References
- 27
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 12 · 2022: 6 · 2021: 13 · 2020: 5 · 2019: 2 · 2018: 4 · 2017: 1
- FWCI
- 2.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Evaluation in Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- ResearchOnline (Glasgow Caledonian University) (acceptedVersion)
- Edith Cowan University Research Online (Edith Cowan University) (submittedVersion)
- Stirling Online Research Repository (University of Stirling) (submittedVersion, public-domain)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, uncontrolled diabetes, glycemic control, HbA1c, nurse-led education, acceptance and commitment therapy, cognitive behavioral therapy, diabetes self-management education, diabetes complications
- MeSH terms
- Self-Management, Blood Glucose, Diabetes Mellitus, Type 2, Diagnostic Techniques, Ophthalmological, Emotions, Female, Glycated Hemoglobin, Humans, Health Knowledge, Attitudes, Practice, Lipids, Male, Mental Health, Nurses, Patient Education as Topic, Cognitive Behavioral Therapy, Patient Satisfaction
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