Diabetes conversation map - a novel tool for diabetes management self-efficacy among type 2 diabetes patients in Pakistan: a randomized controlled trial

• Main Authors: Rubina Qasim, Sarfaraz Masih, Mohammad Tahir Yousafzai, Hakim shah, Abdul Manan, Yousaf Shah, Muhammad Yaqoob, Abida Razzaq, Ajmal Khan, Atiya Rahman Khan Rohilla
• Format: Article
• Language: English
• Published: BMC 2020-06-01
• Series: BMC Endocrine Disorders
• Subjects: Diabetes management; DMSE; Diabetes mellitus type 2; Conversation map; Diabetes education; Diabetes management self-efficacy
• Online Access: http://link.springer.com/article/10.1186/s12902-020-00572-x

Abstract Background This study aimed to measure the effect of diabetes education using the novel method of “diabetes conversation map (DCM)” as compared to routine counselling (RC) on diabetes management self-efficacy (DMSE) among patients living with type 2 diabetes in Karachi, Pakistan. Methods A parallel arm randomized controlled trial among patients with type 2 diabetes aged 30–60 years, with HbA1c > 7%, diagnosed for at least 5 yrs., was conducted at the national institute of diabetes and endocrinology in Karachi, Pakistan. A total 123 type 2 diabetes patients were randomized into DCM (n = 62) or RC (n = 61). Four weekly diabetes control sessions of 40 min each using the DCM or RC was provided. DMSE was measured using a validated Urdu language DMSE tool at baseline and after three months of the randomization. Change in DMSE and HbA1c levels within groups (pre-post) and between the groups after 3 months of enrollment was compared. Results Baseline characteristics except HbA1c were similar between the two arms. After 3 months of enrollment, there was no change in the DMSE score in the RC arm however, significant increase in DMSE score was noted in the DCM arm (P = < 0.001). The average difference (95% confidence interval) in DMSE score between the DCM and RC arm was 33.7(27.3, 40.0; p = < 0.001) after 3 months of the enrollment. Difference in HbA1c within groups was not significant. Conclusions DCM significantly improved DMSE among type 2 diabetes patients in a developing country setting like Pakistan. Healthcare workers caring for type 2 diabetes patients need to be trained on DCM to effectively utilize this novel tool for educating diabetes patients. Trial registration This trial was prospectively registered. ClinicalTrials.gov Identifier: NCT03747471 . Date of registration: Nov 20. 2018.