The Effect of USM-IAM-based Counselling vs Standard Counselling on Insulin Adherence, FBS, and HbA1c among Patients with Uncontrolled Type 2 Diabetes Mellitus (T2DM): A Randomised Controlled Trial
Abstract
Many patients with T2DM on insulin struggle with control despite standard counselling. To address poor insulin adherence, we developed and assessed a new counselling module, USM-IAM, for poorly controlled diabetes patients on insulin therapy.
Methods
Patient eligibility included T2DM diagnosis, age 18-65, HbA1c levels between 8-15%, and one year of insulin therapy. Patients were randomly assigned to receive either USM-IAM-based counselling or standard counselling at baseline and a follow-up visit. They were instructed to adjust insulin doses based on blood glucose levels. Outcomes were evaluated at 3 and 6 months.
Results
Ninety patients were in each group, with similar baseline characteristics. Both groups showed improvements in adherence score and HbA1c, with greater improvement in the USM-IAM group. FBS reductions were significant in the USM-IAM group but not in the standard counselling group.
Conclusion
Both counselling approaches led to significant improvements in adherence score and HbA1c over time, with the USM-IAM group showing higher improvement. Significant FBS reductions were observed in the intervention group compared to the control group.
TRIAL REGISTRATION: Clinicaltrials.gov ID NCT05125185 (17th November 2021).
PMID: 39020348 | DOI: 10.1186/s12902-024-01577-6
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