A community-based lifestyle intervention program for adults with type 2 diabetes mellitus in a low socio-economic status community

[摘要] ENGLISH ABSTRACT : The prevalence, and associated burden of type-two diabetes mellitus (T2DM), is rapidly increasingglobally, and in South Africa, with men and women of all ages being affected. While there has beenan extensive research into the pathophysiological mechanisms, and to some extent, the managementof T2DM, healthcare systems are still not able to adequately deal with the increasing number ofpatients being diagnosed with the disease. Professional- and community-led lifestyle interventionshave recently showed the most promise in combating T2DM. There is however, a paucity of data oncomprehensive lifestyle interventions in communities of low socio-economic status (SES), wherethe incidence of T2DM and its related complications is high.The primary aim of this study was to determine the effectiveness of a community-based, 10-weeklifestyle intervention on physiological, psychological and health-related outcomes in adultssuffering with T2DM in a low SES community.Forty-three participants completed the study (age 59.5 ± 12.2 years, 25 Women; 18 Men), of which23 made up the experimental group (EXP; BMI: 33.8 ± 7.5; HbA1c: 8.8 ± 2.1) and 20 made up thecontrol group (CON; BMI: 34.4 ± 9.7; HbA1c: 9.4 ± 2.3). The control group completed a pre- andpost-testing session, while experimental completed an additional post-testing retention session. Theexperimental group participated in a 10-week comprehensive lifestyle intervention. A number ofanthropometric, cardiovascular and functional measurements were carried out, and questionnairesrelated to health-related quality of life (HRQoL), social support, dietary habits and lifestylebehaviours, as well as health professional usage were also administered.Following the 10-week comprehensive lifestyle intervention, there was a positive change in theoutcome variables measured. There was a statistically significant decrease (p < 0.05) in body fatpercentage, diastolic blood pressure and HbA1c, with a statistically significant increase in the totaldistance walked during the six-minute walk test (6MWT) (p < 0.05). Furthermore, there was astatistically significant improvement (p < 0.05) in all but three of the HRQoL domains. Dietaryhabits and lifestyle behaviours improved significantly (p < 0.05), with the exception of eating timeswhere there was no change. The frequency at which the participants actively sought professionalassistance with the management of their T2DM did not change significantly (p > 0.05). The resultsfrom the retention period, obtained 10-weeks after the conclusion of the intervention, suggest that the changes as a result of the program were maintained, however, it is uncertain if those results canbe attributed to the use of the post-intervention guide.The findings of this study indicate that a 10-week comprehensive lifestyle intervention is effectivein improving physiological, psychological and health-related outcomes in adults with T2DM livingin a low SES community. The use of a post-intervention guide as an assistive device to maintainthese improvements requires further investigation and revision. Furthermore, this study reveals theopportunity for community-based interventions to assist the primary healthcare sector in themanagement and prevention of T2DM.

[发布机构] Stellenbosch University