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一项针对墨西哥裔美国人糖尿病自我管理的随机临床试验:研究参与者的支持者是否能意外获得健康益处?

A randomized clinical trial of diabetes self-management for Mexican Americans: Are there serendipitous health benefits for supporters of study participants?

作者信息

Brown Sharon A, García Alexandra A, Orlander Philip R, Hanis Craig L

机构信息

School of Nursing, The University of Texas at Austin, Austin, TX, USA.

Department of Internal Medicine, UT Health McGovern Medical School, Houston, TX, USA.

出版信息

SAGE Open Med. 2017 Jan 7;5:2050312116682125. doi: 10.1177/2050312116682125. eCollection 2017.

Abstract

OBJECTIVES

Studies of social support in diabetes have focused on the effects of support on the person with type 2 diabetes. We explored diabetes prevention effects of a culturally tailored diabetes self-management intervention in individuals without diabetes who were supporters of intervention participants.

METHODS

This is a secondary analysis of data from a randomized clinical trial that involved 256 Mexican Americans with diabetes. Each study participant designated a supporter-spouse, relative, friend-who attended intervention sessions and assisted participants in attaining effective diabetes self-management. Supporter's glycosylated hemoglobin (A1C) data were tracked for 1 year to determine diabetes conversion rates in supporters without diabetes at baseline.

RESULTS

Fewer individuals in the intervention group (n = 9) converted to an A1C above the 7% threshold, compared to the 1-year wait-listed control group (n = 16). We found a statistically significant difference (p = .021) at 12 months in the number of individuals whose A1C was ⩽8%, with fewer supporters above threshold in the intervention group (reduction of 48%). Supporters in the intervention group with prediabetes, based on baseline A1C, experienced a slight reduction in A1C, while control group supporters with prediabetes experienced an increase.

DISCUSSION

The results suggest that there are potential benefits for family members and other supporters of persons with diabetes who participated in diabetes self-management programs.

摘要

目的

糖尿病领域的社会支持研究主要聚焦于支持对2型糖尿病患者的影响。我们探究了一种针对特定文化背景的糖尿病自我管理干预措施对无糖尿病的干预参与者支持者的糖尿病预防效果。

方法

这是一项对随机临床试验数据的二次分析,该试验涉及256名患有糖尿病的墨西哥裔美国人。每位研究参与者指定一名支持者——配偶、亲属、朋友——他们参加干预课程并协助参与者实现有效的糖尿病自我管理。对支持者的糖化血红蛋白(A1C)数据进行了为期1年的跟踪,以确定基线时无糖尿病的支持者的糖尿病转化率。

结果

与1年等待列表对照组(n = 16)相比,干预组中糖化血红蛋白(A1C)超过7%阈值的转化个体较少(n = 9)。我们发现在12个月时,A1C≤8%的个体数量存在统计学显著差异(p = 0.021),干预组中超过阈值的支持者较少(减少了48%)。根据基线A1C,干预组中患有糖尿病前期的支持者的A1C略有下降,而对照组中患有糖尿病前期的支持者的A1C则有所上升。

讨论

结果表明,对于参与糖尿病自我管理项目的糖尿病患者的家庭成员和其他支持者而言,存在潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1257/5308430/b4ad43fb9149/10.1177_2050312116682125-fig1.jpg

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