An Educational Intervention Using Steno Balance Cards to Improve Glycemic Control in Patients With Poorly Controlled Type 2 Diabetes Mellitus.
Yueh-Chu Wu, Edy Kornelius, Yi-Sun Yang and 2 others
PMID 30085990WHAT IT FOUND
In adults with poorly controlled diabetes, group Steno Balance Card education produced a larger fall in HbA1c than routine clinic education, but added peer support and phone calls mean the cards alone may not explain the benefit.
Key findings
01At 6 months, HbA1c fell from 8.1% to 6.8% in the Steno Balance Card group and from 8.0% to 7.4% in standard care, with a greater reduction in the card group.
02The card group increased blood glucose monitoring, reduced carbohydrate intake, and increased weekly exercise more than the standard care group.
03Well-being and SF-12 mental and physical health scores improved more in the card group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Assignment was not fully random because only the first participant was assigned by coin toss and later participants were alternately assigned. The researchers knew group status, and one researcher delivered the intervention, which could bias support and measurement. The intervention group received extra group peer support and telephone reminders, so the benefit of the Steno Balance Cards alone cannot be separated. The study was done in one centre in Taiwan, and the authors say results may not generalise to other cultures or age groups. Missing data and dropouts were replaced with preceding values rather than actual 6-month measurements. No cost-benefit analysis was done compared with conventional one-on-one education.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that the Steno Balance Cards alone caused better control. The card group also received group peer support and telephone reminders, and the authors state that the benefit cannot be separated from those components.