Lifestyle Counseling in Primary Care Setting Reduces Treatment Goals for DiabeticsThursday, February 16, 2012
Lifestyle counseling, practiced as part of routine care for people with diabetes, helps people more quickly lower blood glucose, blood pressure and cholesterol levels and keep them under control, according to a large, long-term study published in the February issue of Diabetes Care (not affiliated with DiabetesCare.net).
Researchers at Brigham and Women`s Hospital (BWH) conducted a retrospective cohort study of more than 30,000 people with diabetes who received diet, exercise and weight-loss counseling in a primary care setting over the course of at least two years (with an average follow-up time of almost seven years) and who had elevated blood glucose, blood pressure or cholesterol.
They found that the use of counseling reduced the time it took for patients to lower blood glucose, blood pressure and cholesterol levels. Previous studies have documented the success of counseling in a clinical trial setting, but until now many have questioned whether it would be as effective when conducted as part of ongoing treatment in a primary care setting, where fewer resources are available and patients may be less motivated.
"This study shows that persistent lifestyle counseling can and should be a critical piece of any routine diabetes treatment plan," said senior author Alexander Turchin, MD, MS, director of informatics research at the BWH Division of Endocrinology. "Clearly it gets people to goals faster than when they are not given continued encouragement and information on how to increase physical activity levels, eat properly and reduce lipids. Primary care providers should take these findings to heart."
The study found that the more frequently patients received counseling, the faster they reached their treatment goals, with those who received counseling at least once a month achieving the best results. Those who received face-to-face counseling once a month or more took an average of 3.9 weeks to reach their target goals for A1C, blood pressure and cholesterol, as compared to 13.5 months for those who received counseling only once every one to six months.
Because counseling can be time intensive, researchers recommend that working with providers such as nurse practitioners, physician assistants or dietitians, as well as providing support in group settings, may be more cost-effective ways of providing this necessary support.
This research was supported by the Agency for Healthcare Research and Quality, National Library of Medicine, and Diabetes Action Research and Education Foundation.