Diabetes Technol Ther. 2022 Nov 21. doi: 10.1089/dia.2022.0419. Online ahead of print.
ABSTRACT
BACKGROUND: The majority of individuals referred to diabetes self-management education and support (DSMES) programs do not access this resource. Of those who do, attrition is high, with anecdotal reports pointing to the didactic and impersonal nature of these programs contributing to low utilization and completion rates. In an effort to develop a more engaging form of DSMES for adults with type 2 diabetes (T2D), we constructed a non-didactic, “discovery learning”-based DSMES program centered on real-time flash glucose monitoring (FGM).
METHODS: In this single-arm pilot study, 35 adults with T2D duration 1 – 5 years, ages 21 – 75 years, not using insulin and HbA1c >8.0% were introduced to FGM and participated in five weekly group sessions. DSMES content was personalized, emerging from the concerns and questions arising from participants’ FGM discoveries. The primary outcome was glycemic change as assessed by blinded FGM at baseline and month 3. Secondary outcomes included psychosocial and behavioral measures.
RESULTS: There was a significant gain in % TIR 70 -180 mg/dL from baseline (55%) to month 3 (74%), and a parallel drop in TAR > 180 mg/dL from 44% to 25% (ps = 0.01). Overall well-being rose significantly (p = 0.04), while diabetes distress showed a non-significant drop. Participants reported improvements in healthy eating (p < 0.001) and physical activity, though the latter did not reach statistical significance.
CONCLUSIONS: These findings support a new approach to DSMES, a method that integrates FGM with a highly interactive and engaging, patient-driven, “discovery learning” approach to education.
PMID:36409486 | DOI:10.1089/dia.2022.0419
