School of Health, Business and Natural Sciences-Faculty of Nursing, University of Akureyri, Akureyri, 600, Iceland.
Health Care Institution of North Iceland, Siglufjordur, 580, Iceland.
BMC Public Health. 2024 Nov 1;24(1):3035. doi: 10.1186/s12889-024-20538-1.
Identify individuals who are at risk of Type 2 diabetes, who also are at a greater risk of developing cardiovascular disease is important. The rapid worldwide increase in diabetes prevalence call for Primary Health Care to find feasible prevention strategies, to reduce patient risk factors and promote lifestyle changes. Aim of this randomized controlled trial was to investigate how a nurse-lead Guided Self-Determination counselling approach can assist people at risk of type 2 diabetes to lower their coronary heart disease risk.
In this randomized controlled study, 81 people at risk of developing type 2 diabetes were assigned into an intervention group (n = 39) receiving Guided Self-Determination counselling from Primary Health Care nurses over three months and a control group (n = 42) that received a diet leaflet only. Measurements included the Finnish Diabetes Risk Score questionnaire and biological measurements of Hemoglobin A1c protein, Body Mass Index, fasting blood glucose, Blood pressure, Cholesterol, High-density lipoprotein, and triglycerides, at baseline (time1), 6 (time2) and 9 months (time 3).
A total of 56 participants, equal number in intervention and control groups, completed all measurements. A significant difference between the intervention and control groups, in coronary heart disease risk was not found at 6 nor 9-months. However, within-group data demonstrated that 55.4% of the participants had lower coronary heart disease risk in the next ten years at the 9-month measurement. Indicating an overall 18% relative risk reduction of coronary heart disease risk by participating in the trial, with the number needed to treat for one to lower their risk to be nine. Within the intervention group a significant difference was found between time 1 and 3 in lower body mass index (p = 0.046), hemoglobin A1c level (p = 0.018) and diastolic blood pressure (p = 0.03).
Although unable to show significant group differences in change of coronary heart disease risk by this 12-weeks intervention, the process of regular measurements and the guided self-determination counselling seem to be beneficial for within-group measures and the overall reduction of coronary heart disease risk factors.
This study is a part of the registered study 'Effectiveness of Nurse-coordinated Follow-Up Programme in Primary Care for People at Risk of T2DM' at www.
gov (NCT04688359) (accessed on 30 December 2020).
识别患有 2 型糖尿病风险的个体，以及那些有更高心血管疾病风险的个体是很重要的。糖尿病患病率在全球范围内的迅速增长，要求基层医疗保健机构寻找可行的预防策略，降低患者的风险因素并促进生活方式的改变。本随机对照试验的目的是研究护士主导的自主指导咨询方法如何帮助有 2 型糖尿病风险的人降低冠心病风险。
在这项随机对照研究中，81 名有发展为 2 型糖尿病风险的人被分配到干预组（n=39），他们在三个月内接受初级保健护士的自主指导咨询，对照组（n=42）仅接受饮食传单。测量包括芬兰糖尿病风险评分问卷和血红蛋白 A1c 蛋白、体重指数、空腹血糖、血压、胆固醇、高密度脂蛋白和甘油三酯的生物测量，在基线（时间 1）、6 个月（时间 2）和 9 个月（时间 3）。
共有 56 名参与者，干预组和对照组各有 28 名，完成了所有测量。在 6 个月和 9 个月时，干预组和对照组之间的冠心病风险差异均无统计学意义。然而，组内数据显示，在 9 个月的测量中，55.4%的参与者在未来十年内冠心病风险较低。这表明通过参与试验，冠心病风险相对降低了 18%，需要治疗的人数为 9 人，以降低他们的风险。在干预组中，时间 1 与时间 3 之间的身体质量指数（p=0.046）、血红蛋白 A1c 水平（p=0.018）和舒张压（p=0.03）显著降低。
尽管本 12 周干预未能显示出冠心病风险变化的显著组间差异，但定期测量和自主指导咨询的过程似乎对组内措施和冠心病风险因素的整体降低有益。
这项研究是在 www.clinicaltrials.gov 上注册的研究“在初级保健中护士协调的随访计划对 T2DM 风险人群的有效性”的一部分（NCT04688359）（于 2020 年 12 月 30 日访问）。
