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Integration of Health Coaching and Diabetes Education in Type 2 Diabetes Mellitus Management at Primary Health Care

Not Applicable
Conditions
Type2 Diabetes
Diabetes Mellitus
Diabetes Mellitus, Type 2
Nutritional and Metabolic Diseases
Endocrine System Diseases
Glucose Metabolism Disorders (Including Diabetes Mellitus)
Interventions
Behavioral: Personal Health Coaching and Diabetes Education in Group
Registration Number
NCT05090488
Lead Sponsor
Indonesia University
Brief Summary

Type 2 Diabetes Mellitus is a chronic disease with increasing incidence globally. It needs a comprehensive and continuous management approach that includes five pillars: education, nutritional management, physical activity, pharmacological treatment, and monitoring. To achieve good glycemic control, prevention of complications, and good quality of life as diabetes management goals, patients' capability to properly navigate diabetes management is a key. One evidence-based model to empower patients' self-management abilities is diabetes education and health coaching. Diabetes management at primary health care needs special concern since they play an important role in initial and continuing care for diabetes patients in the community. Therefore, the implementation of diabetes education and health coaching in primary health care is expected to improve the self-management abilities of people with diabetes

Detailed Description

A randomized control trial, pre and post study involving 180 subjects randomized into 2 arms:

* Control : received education in group

* Intervention : received education group + personal health coaching Education group divided into 6 session, which for each session consist of 2 different topics and lasts for 60 minutes.

Health coaching was given by a coach, a healthcare professional who undergo training to become a coach. Health coaching delivered as face to face between subjects and coach.

Laboratory examination, anthropometric measurement, echocardiography, electrocardiography, Heart Rate Variability measurement, diabetic eye screening, and questionnaire collected at baseline, 3 and 6 months after intervention

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Type 2 Diabetes Mellitus
  • >= 18 years old
  • Willing to follow the research by signing an informed consent
Exclusion Criteria
  • Patients with cognitive disease (such as dementia)
  • Patients with hearing or sight problem
  • Unable to live independently on daily basis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Received Diabetes Education in GroupPersonal Health Coaching and Diabetes Education in GroupDiabetes education in group, with trained educator team from primary health care
Received Personal Health Coaching and Diabetes Education in GroupPersonal Health Coaching and Diabetes Education in GroupHealth coaching was given as face to face with a trained coach from primary health care. Diabetes education in group, with trained educator team from primary health care
Primary Outcome Measures
NameTimeMethod
Change from baseline HbA1C at 3 months and 6 monthsBaseline, 3 and 6 months after intervention

HbA1C is indicator of glycemic control

Secondary Outcome Measures
NameTimeMethod
Change from baseline body mass indexBaseline, 3 and 6 months after intervention

Body mass index described by kg/m2

Change from baseline right ventricular systolic functionBaseline, 6 months after intervention

Right ventricular systolic function was evaluated using TAPSE

Change from baseline fasting plasma glucose at 3 and 6 monthsBaseline, 3 and 6 months after intervention

Blood glucose monitoring

Change from baseline serum lipid at 3 and 6 monthsBaseline, 3 and 6 months after intervention

Lipid profile measurement includes total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides

change from baseline left ventricular diastolic functionBaseline, 6 months after intervention

LV diastolic function was evaluated according to algorithm recommended by American Society of Echochardiography in 2016

Baseline visual acuityBaseline

Visual acuity was measured by Peek acuity chart application using WHO classification

Baseline lens hazinessBaseline

Lens haziness was evaluated using shadow test

Change from baseline peripheral autonomic neuropathyBaseline, 3 and 6 months after intervention

Peripheral autonomic neuropathy was seen visually by objective examination (dry, scaly skin and cracked skin)

Change from baseline left ventricular systolic functionBaseline, 6 months after intervention

Left ventricular systolic funciton was calculated from ejection fraction and global longitudinal strain (measured by echocardiography)

Change from baseline inflammatory marker at 3 and 6 monthsBaseline, 3 and 6 months after intervention

Inflammatory marker used is hs-CRP (C-reactive protein)

Baseline retina examinationBaseline

Retina was examined using funduscopic photography

Baseline intraocular pressureBaseline

Intraocular pressure was measured by cup-to-disc ratio using funduscopic photograpy

Change from baseline mean calorie intakeBaseline, 3 and 6 months after intervention

Evaluation of mean calorie intake using food record data

Change from baseline body fatBaseline, 3 and 6 months after intervention

Body fat measured by body impedance analysis

Change from baseline left atrial volumeBaseline, 6 months after intervention

Left atrial volume was measured through biplane area calculation in echocardiography procedure

Change from baseline electrocardiography patternBaseline and 6 months after intervention

Electrocardiography pattern was used to analyze cardiac rythm

Change from baseline peripheral arterial diseaseBaseline, 3 and 6 months after intervention

Peripheral arterial disease was diagnosed through ankle brachial index measurement

Change from baseline waist circumferenceBaseline, 3 and 6 months after intervention

Waist circumference measured by cm

Change from baseline left ventricular mass indexBaseline, 6 months after intervention

Left ventricular mass index measured using standard formula and corrected by body surface area

Change from baseline heart rate variabilityBaseline and 6 months after intervention

Heart rate variability was measured using ECG Holter examination

Change from baseline peripheral sensory neuropathyBaseline, 3 and 6 months after intervention

Peripheral sensory neuropathy was measured using combination of subjective manifestation, 10 g Simme Weinstein monofilament and 128 Hz tuning fork

Change from baseline albuminuriaBaseline and 6 months after intervention

Albuminuria was measured by albumin creatinine ratio

Change from baseline peripheral motor neuropathyBaseline, 3 and 6 months after intervention

Peripheral motor neuropathy was seen visually by objective examination (changes in the shape of fingers, muscle atrophy, or bone protrusions)

Change from baseline renal functionBaseline and 6 months after intervention

Renal function was measured by estimated glomerular filtration rate (eGFR) using creatinine data

Change from baseline medication adherenceBaseline, 3 and 6 months

Medication adherence was measured by Morisky Medication Adherence Scale (MMAS)

Change from baseline quality of lifeBaseline, 3 and 6 months

Quality of life was evaluated by EuroQol five-dimensional questionnaire. This questionnaire evaluates 5 dimensions of life. Each dimension scores 1-5 (1 means no problem and 5 means extreme problems).

Change from baseline global physical activityBaseline, 3 and 6 months after intervention

Global physical activity was evaluated by global physical activity questionnaire

Trial Locations

Locations (1)

University of Indonesia

🇮🇩

Jakarta, DKI Jakarta, Indonesia

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