Creating Effective Self-Management for Type 2 Diabetes in Persons with Dementia

为痴呆症患者建立有效的 2 型糖尿病自我管理

• 批准号: 8286894
• 负责人: Cameron J Camp
• 金额: $ 23.7万
• 依托单位: LINDA AND CAMERON, INC.
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8286894
• 关键词: Address; Alzheimer' s Disease; Behavior; Blood Glucose; Camping; Case Manager; Cause of Death; Cholesterol; Clinical; Cognitive; Collaborations; Cost Analysis; Coupled; Death Rate; Dementia; Development; Diabetes Mellitus; Diet; Education; Educational Materials; Elderly; Epidemiologic Studies; Foundations; Frequencies; Funding; Future; Grant; HIV; Home environment; Impaired cognition; Individual; Intervention; Learning; Life; Life Style; Measures; Memory impairment; Monitor; Moods; NIH Program Announcements; National Institute of Mental Health; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Oral; Outcome; Outcome Measure; Participant; Patients; Persons; Pharmaceutical Preparations; Physiological; Pilot Projects; Population; Prevention; Psychological reinforcement; Public Health; Randomized; Research; Retirement; Retrieval; Risk; Risk Factors; Sampling; Self Efficacy; Self Management; Serum; Staging; Telephone; Testing; Time; Training; Translational Research; Translations; Vascular Dementia; Work; design; diabetes control; diabetes educator; diabetic; glucose monitor; glycemic control; health care service utilization; improved; pill; post intervention; primary outcome; psychologic; response; satisfaction; sedentary; therapy design

DESCRIPTION (provided by applicant): As the number of older adults in the U.S. increases, the population of older adults living with co-existing Type 2 diabetes and dementia is increasing. These older adults are at risk for poor self-management of medications for diabetes, poor glycemic control, and subsequent serious complications. As such, this little- studied subpopulation of those living with diabetes constitutes a growing public health concern. Among older adults, diabetes mellitus is one of the few causes of death that is increasing in frequency, with the death rate for Type 2 diabetes increasing 45% since 1987. With increasing frequency of obesity and sedentary lifestyles in the U.S. population, diabetes will become more prevalent, especially among older adults. The purpose of this study is to determine if diabetes educational materials designed for persons with early dementia, coupled with a cognitive intervention (Space Retrieval - SR), improve self-management of medications and blood glucose monitoring and subsequent glycemic control for older adults living with both Type 2 diabetes and dementia. Objectives of the study are as follows: (1) To determine the extent to which strategies developed to improve self-management behaviors related to medications and blood glucose monitoring for older adults with Type 2 diabetes and early stage dementia can be learned, and under what conditions, using netbooks for intervention. (2) To determine whether such strategies, once learned, can be implemented successfully; and, (3) To examine the relationship between strategy learning and implementation and changes in both psychological and physiological outcomes associated with successful glycemic control. Forty-eight older adults with Type 2 diabetes and early dementia, taking oral diabetic medications only, will be randomly assigned to either a Standard Education or Standard Education + SR group. Standard Education sessions for self-management of diabetes will be delivered via netbooks with Skype by Certified Diabetes Educators. Effects produced by this condition will be compared with those produced by a Standard Education + SR condition. Both groups will participate in two Initial Education sessions designed to improve medication-taking and blood glucose monitoring through the development of two individualized self-monitoring strategies. Both groups will then participate in 8 Additional Education sessions, focused on diet self-management. The SR group will receive this education with embedded SR treatment designed to enhance retention and implementation of the original two individualized self- monitoring strategies. Primary outcome measures, compared between groups, and measured at 1, 3, and 6-months post-intervention include strategy learning and strategy implementation. Additional outcomes include mood state and perceived self-efficacy for managing diabetes. Satisfaction with the use of netbooks, and HgA1c and serum cholesterol panels, will be assessed at final posttest. Cost analyses and health care utilization measures will be developed, as well, to assist in future translation efforts.

描述（由申请人提供）：随着美国老年人数量的增加，同时患有2型糖尿病和痴呆症的老年人人数也在增加。这些老年人有糖尿病药物自我管理不良、血糖控制不良和随后严重并发症的风险。因此，这一很少被研究的糖尿病患者亚群构成了一个日益增长的公共卫生问题。在老年人中，糖尿病是频率增加的少数死亡原因之一，自1987年以来，2型糖尿病的死亡率增加了45%。随着美国人口中肥胖和久坐不动的生活方式的频率增加，糖尿病将变得更加普遍，特别是在老年人中。本研究的目的是确定为早期痴呆患者设计的糖尿病教育材料，加上认知干预（空间检索- SR），是否改善了2型糖尿病和痴呆老年人的药物自我管理和血糖监测以及随后的血糖控制。本研究的目的如下：（1）确定为改善2型糖尿病和早期痴呆老年人的药物和血糖监测相关的自我管理行为而制定的策略在多大程度上可以学习，以及在什么情况下，使用上网本进行干预。(2)以确定这些策略，一旦学习，是否可以成功地实施;和，（3）检查策略学习和实施之间的关系，并与成功的血糖控制相关的心理和生理结果的变化。48名患有2型糖尿病和早期痴呆的老年人，仅服用口服糖尿病药物，将被随机分配到标准教育组或标准教育+ SR组。糖尿病自我管理的标准教育课程将由认证的糖尿病教育工作者通过带有Skype的上网本提供。这种情况下产生的效果将与标准教育+ SR条件下产生的效果进行比较。两组都将参加两个初始教育课程，旨在通过制定两个个性化的自我监测策略来改善服药和血糖监测。然后，两组都将参加8个额外的教育课程，重点是饮食自我管理。SR组将接受这种教育与嵌入式SR治疗，旨在加强保留和执行原来的两个个性化的自我监测战略。在干预后1个月、3个月和6个月进行组间比较的主要结果指标包括策略学习和策略实施。其他结果包括情绪状态和管理糖尿病的自我效能感。使用上网本的满意度，以及HgA 1c和血清胆固醇面板，将在最后的后测中进行评估。还将进行费用分析和制订保健利用措施，以协助今后的翻译工作。