Integrating Medical Management With Diabetes Self-Management Training: A randomized control trial of the Diabetes Outpatient Intensive Treatment program

William H. Polonsky, Jay Edward Earles, Susan Smith, Donna J. Pease, Mary Macmillan, Reed Christensen, Thomas Taylor, Judy Dickert, Richard A. Jackson

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

OBJECTIVE - This study evaluated the Diabetes Outpatient Intensive Treatment (DOIT) program, a multiday group education and skills training experience combined with daily medical management, Followed by case management over 6 months. Using a randomized control design, the study explored how DOIT affected glycemic control and self-care behaviors over a short term. The impact of two additional factors on clinical outcomes were also examined (frequency of case management contacts and whether or not insulin was started during the program). RESEARCH DESIGN AND METHODS - Patients with type 1 and type 2 diabetes in poor glycemic control (Alc >8.5%) were randomly assigned to DOIT or a second condition, entitled EDUPOST, which was standard diabetes care with the addition of quarterly educational mailings. A total of 167 patients (78 EDUPOST, 89 DOIT) completed all baseline measures, including Alc and a questionnaire assessing diabetes-related self-care behaviors. At 5 months, 117 patients (52 EDUPOST, 65 DOIT) returned to complete a follow-up Alc and the identical self-care questionnaire. RESULTS - At follow-up, DOIT evidenced a significantly greater drop in Alc than EDUPOST. DOIT patients also reported significantly more frequent blood glucose monitoring and greater attention to carbohydrate and fat contents (ACFC) of food compared with EDUPOST patients. An increase in ACFC over the 6-month period was associated with improved glycemic control among DOIT patients. Also, the frequency of nurse case manager follow-up contacts was positively linked to better Alc outcomes. The addition of insulin did not appear to be a significant contributor to glycemic change. CONCLUSIONS - DOIT appears to be effective in promoting better diabetes care and positively influencing glycemia and diabetes-related self-care behaviors. However, it demands significant time, commitment, and careful coordination with many health care professionals. The role of the nurse case manager in providing ongoing follow-up contact seems important.

Original languageEnglish (US)
Pages (from-to)3048-3053
Number of pages6
JournalDiabetes Care
Volume26
Issue number11
DOIs
StatePublished - Nov 1 2003
Externally publishedYes

Fingerprint

Self Care
Outpatients
Therapeutics
Case Management
Fats
Carbohydrates
Insulin
Nurse's Role
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Blood Glucose
Research Design
Nurses
Delivery of Health Care
Education
Food

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Polonsky, W. H., Earles, J. E., Smith, S., Pease, D. J., Macmillan, M., Christensen, R., ... Jackson, R. A. (2003). Integrating Medical Management With Diabetes Self-Management Training: A randomized control trial of the Diabetes Outpatient Intensive Treatment program. Diabetes Care, 26(11), 3048-3053. https://doi.org/10.2337/diacare.26.11.3048

Integrating Medical Management With Diabetes Self-Management Training : A randomized control trial of the Diabetes Outpatient Intensive Treatment program. / Polonsky, William H.; Earles, Jay Edward; Smith, Susan; Pease, Donna J.; Macmillan, Mary; Christensen, Reed; Taylor, Thomas; Dickert, Judy; Jackson, Richard A.

In: Diabetes Care, Vol. 26, No. 11, 01.11.2003, p. 3048-3053.

Research output: Contribution to journalArticle

Polonsky, WH, Earles, JE, Smith, S, Pease, DJ, Macmillan, M, Christensen, R, Taylor, T, Dickert, J & Jackson, RA 2003, 'Integrating Medical Management With Diabetes Self-Management Training: A randomized control trial of the Diabetes Outpatient Intensive Treatment program', Diabetes Care, vol. 26, no. 11, pp. 3048-3053. https://doi.org/10.2337/diacare.26.11.3048
Polonsky, William H. ; Earles, Jay Edward ; Smith, Susan ; Pease, Donna J. ; Macmillan, Mary ; Christensen, Reed ; Taylor, Thomas ; Dickert, Judy ; Jackson, Richard A. / Integrating Medical Management With Diabetes Self-Management Training : A randomized control trial of the Diabetes Outpatient Intensive Treatment program. In: Diabetes Care. 2003 ; Vol. 26, No. 11. pp. 3048-3053.
@article{777b55909f5c487e859ac2e65b50b056,
title = "Integrating Medical Management With Diabetes Self-Management Training: A randomized control trial of the Diabetes Outpatient Intensive Treatment program",
abstract = "OBJECTIVE - This study evaluated the Diabetes Outpatient Intensive Treatment (DOIT) program, a multiday group education and skills training experience combined with daily medical management, Followed by case management over 6 months. Using a randomized control design, the study explored how DOIT affected glycemic control and self-care behaviors over a short term. The impact of two additional factors on clinical outcomes were also examined (frequency of case management contacts and whether or not insulin was started during the program). RESEARCH DESIGN AND METHODS - Patients with type 1 and type 2 diabetes in poor glycemic control (Alc >8.5{\%}) were randomly assigned to DOIT or a second condition, entitled EDUPOST, which was standard diabetes care with the addition of quarterly educational mailings. A total of 167 patients (78 EDUPOST, 89 DOIT) completed all baseline measures, including Alc and a questionnaire assessing diabetes-related self-care behaviors. At 5 months, 117 patients (52 EDUPOST, 65 DOIT) returned to complete a follow-up Alc and the identical self-care questionnaire. RESULTS - At follow-up, DOIT evidenced a significantly greater drop in Alc than EDUPOST. DOIT patients also reported significantly more frequent blood glucose monitoring and greater attention to carbohydrate and fat contents (ACFC) of food compared with EDUPOST patients. An increase in ACFC over the 6-month period was associated with improved glycemic control among DOIT patients. Also, the frequency of nurse case manager follow-up contacts was positively linked to better Alc outcomes. The addition of insulin did not appear to be a significant contributor to glycemic change. CONCLUSIONS - DOIT appears to be effective in promoting better diabetes care and positively influencing glycemia and diabetes-related self-care behaviors. However, it demands significant time, commitment, and careful coordination with many health care professionals. The role of the nurse case manager in providing ongoing follow-up contact seems important.",
author = "Polonsky, {William H.} and Earles, {Jay Edward} and Susan Smith and Pease, {Donna J.} and Mary Macmillan and Reed Christensen and Thomas Taylor and Judy Dickert and Jackson, {Richard A.}",
year = "2003",
month = "11",
day = "1",
doi = "10.2337/diacare.26.11.3048",
language = "English (US)",
volume = "26",
pages = "3048--3053",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "11",

}

TY - JOUR

T1 - Integrating Medical Management With Diabetes Self-Management Training

T2 - A randomized control trial of the Diabetes Outpatient Intensive Treatment program

AU - Polonsky, William H.

AU - Earles, Jay Edward

AU - Smith, Susan

AU - Pease, Donna J.

AU - Macmillan, Mary

AU - Christensen, Reed

AU - Taylor, Thomas

AU - Dickert, Judy

AU - Jackson, Richard A.

PY - 2003/11/1

Y1 - 2003/11/1

N2 - OBJECTIVE - This study evaluated the Diabetes Outpatient Intensive Treatment (DOIT) program, a multiday group education and skills training experience combined with daily medical management, Followed by case management over 6 months. Using a randomized control design, the study explored how DOIT affected glycemic control and self-care behaviors over a short term. The impact of two additional factors on clinical outcomes were also examined (frequency of case management contacts and whether or not insulin was started during the program). RESEARCH DESIGN AND METHODS - Patients with type 1 and type 2 diabetes in poor glycemic control (Alc >8.5%) were randomly assigned to DOIT or a second condition, entitled EDUPOST, which was standard diabetes care with the addition of quarterly educational mailings. A total of 167 patients (78 EDUPOST, 89 DOIT) completed all baseline measures, including Alc and a questionnaire assessing diabetes-related self-care behaviors. At 5 months, 117 patients (52 EDUPOST, 65 DOIT) returned to complete a follow-up Alc and the identical self-care questionnaire. RESULTS - At follow-up, DOIT evidenced a significantly greater drop in Alc than EDUPOST. DOIT patients also reported significantly more frequent blood glucose monitoring and greater attention to carbohydrate and fat contents (ACFC) of food compared with EDUPOST patients. An increase in ACFC over the 6-month period was associated with improved glycemic control among DOIT patients. Also, the frequency of nurse case manager follow-up contacts was positively linked to better Alc outcomes. The addition of insulin did not appear to be a significant contributor to glycemic change. CONCLUSIONS - DOIT appears to be effective in promoting better diabetes care and positively influencing glycemia and diabetes-related self-care behaviors. However, it demands significant time, commitment, and careful coordination with many health care professionals. The role of the nurse case manager in providing ongoing follow-up contact seems important.

AB - OBJECTIVE - This study evaluated the Diabetes Outpatient Intensive Treatment (DOIT) program, a multiday group education and skills training experience combined with daily medical management, Followed by case management over 6 months. Using a randomized control design, the study explored how DOIT affected glycemic control and self-care behaviors over a short term. The impact of two additional factors on clinical outcomes were also examined (frequency of case management contacts and whether or not insulin was started during the program). RESEARCH DESIGN AND METHODS - Patients with type 1 and type 2 diabetes in poor glycemic control (Alc >8.5%) were randomly assigned to DOIT or a second condition, entitled EDUPOST, which was standard diabetes care with the addition of quarterly educational mailings. A total of 167 patients (78 EDUPOST, 89 DOIT) completed all baseline measures, including Alc and a questionnaire assessing diabetes-related self-care behaviors. At 5 months, 117 patients (52 EDUPOST, 65 DOIT) returned to complete a follow-up Alc and the identical self-care questionnaire. RESULTS - At follow-up, DOIT evidenced a significantly greater drop in Alc than EDUPOST. DOIT patients also reported significantly more frequent blood glucose monitoring and greater attention to carbohydrate and fat contents (ACFC) of food compared with EDUPOST patients. An increase in ACFC over the 6-month period was associated with improved glycemic control among DOIT patients. Also, the frequency of nurse case manager follow-up contacts was positively linked to better Alc outcomes. The addition of insulin did not appear to be a significant contributor to glycemic change. CONCLUSIONS - DOIT appears to be effective in promoting better diabetes care and positively influencing glycemia and diabetes-related self-care behaviors. However, it demands significant time, commitment, and careful coordination with many health care professionals. The role of the nurse case manager in providing ongoing follow-up contact seems important.

UR - http://www.scopus.com/inward/record.url?scp=0242332273&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0242332273&partnerID=8YFLogxK

U2 - 10.2337/diacare.26.11.3048

DO - 10.2337/diacare.26.11.3048

M3 - Article

C2 - 14578238

AN - SCOPUS:0242332273

VL - 26

SP - 3048

EP - 3053

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 11

ER -