Motivational interviewing delivered by diabetes educators: Does it improve blood glucose control among poorly controlled type 2 diabetes patients?

• Published in: Diabetes research and clinical practice Vol. 91; no. 1; pp. 54 - 60
• Main Authors: Welch, Garry, Zagarins, Sofija E, Feinberg, Rebecca G, Garb, Jane L
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.01.2011
• Subjects: Adult; Aged; Allied Health Personnel - education; Anxiety - etiology; Anxiety - physiopathology; Behavior Therapy; Blood glucose control; Computer-Assisted Instruction; Cost of Illness; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; Diabetes self management education (DSME); Endocrinology & Metabolism; Female; Glycated Hemoglobin A - analysis; HbA1c; Humans; Hyperglycemia - prevention & control; Male; Middle Aged; Motivation; Motivational interviewing; Patient Compliance; Patient Dropouts; Patient Education as Topic - methods; Psychiatric Status Rating Scales; Self Care; Type 2 diabetes; Type 2 diabetes; Diabetes self management education (DSME); Motivational interviewing; Blood glucose control; HbA1c
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2010.09.036

Abstract Aim To determine whether glycemic control is improved when motivational interviewing (MI), a patient-centered behavior change strategy, is used with diabetes self management education (DSME) as compared to DSME alone. Methods Poorly controlled type 2 diabetes (T2DM) patients ( n = 234) were randomized into 4 groups: MI + DSME or DSME alone, with or without use of a computerized summary of patient self management barriers. We compared HbA1c changes between groups at 6 months and investigated mediators of HbA1c change. Results Study patients attended the majority of the four intervention visits (mean 3.4), but drop-out rate was high at follow-up research visits (35%). Multiple regression showed that groups receiving MI had a mean change in HbA1c that was significantly lower (less improved) than those not receiving MI ( t = 2.10; p = 0.037). Mediators of HbA1c change for the total group were diabetes self-care behaviors and diabetes distress; no between-group differences were found. Conclusions DSME improved blood glucose control, underlining its benefit for T2DM management. However, MI + DSME was less effective than DSME alone. Overall, weak support was found for the clinical utility of MI in the management of T2DM delivered by diabetes educators.