In the past few weeks, the results of several studies have come out with very interesting results. All of them have been concerned with helping those of us with diabetes do a better job of managing our lives using different methods of training, support and tracking. The results varied remarkably, but one point seems clear — personal support and coaching works.
A Reuter’s report on a review of 16 prior studies of computer and mobile phone based programs designed to “provide tailored advice and support to people with diabetes” found that they did little or nothing to improve participants health or quality of life. 3600 people in the US, UK, South Korea and China participated in the included studies.
Disappointingly, only a 0.2% improvement in A1c was made overall, and while 5 of 6 reports found participants improved their diets, just 2 found any increase in exercise but with no effect on weight. Even more disappointingly, the studies that hinted that people’s knowledge and confidence increased also showed no improvement in depression. One of the researchers concluded “we learned people needed an individualized approach to manage their diabetes, feedback and communication with a trusted source (health provider, diabetes educator, trained layperson or peer).” In other words, it’s people that make a difference.
This is exactly what the other 2 studies found in very different settings. In the first, selected Washington State pharmacy students were trained to provide telephone coaching to residents of rural Washington communities with high rates of diabetes to reduce rates of hospitalization and severe diabetes related health complications and to increase their clients self-management capabilities.
Residents first participated in “On the Road to Living Well with Diabetes” and then received 8 weeks of telephone coaching for self-care strategies, blood glucose monitoring, taking medications, following diet and exercise programs and keeping up with regular medical care.
About 80% of the participants agreed that the encouragement they received from coaching was important in helping them figure out individually how to better control their diabetes. More than half wanted to continue their coaching. Their success was confirmed by their A1c’s. Those with the highest pre-study levels, had post-study levels down by 1.3 point after 3 months.
In a second study involving 6 public health clinics in San Francisco, peer coaches were trained. While those coached were noted to have limited resources and face cultural, language and literacy barriers to self-management, they still showed full 1 point drops in their A1c’s after 6 months.
If you’re not where you want to be with your self-management, find someone to buddy up with. You can work together to figure out what works, to encourage one another and help keep each other on track.