improvement of diabetes management from health intervention in India

Introduction

Diabetes management in India faces unique challenges due to the country's diverse population, varying levels of healthcare access, and cultural factors. Various health interventions have been implemented to improve diabetes management, focusing on lifestyle changes, patient education, and healthcare system improvements. This synthesis reviews the effectiveness of these interventions based on multiple research studies.

Key Insights

Lifestyle Interventions:
- Yoga, meditation, and exercise interventions in India have shown significant reductions in HbA1c levels and improvements in other health metrics such as BMI and waist circumference .
- Dietary education, including cooking exercises and text message reminders, has led to improved dietary habits and reduced diabetes incidence among high-risk individuals .
Patient Education and mHealth:
- mHealth interventions, such as text messaging programs, have been effective in improving diabetes-related health behaviors, including better fruit, vegetable, and fat intake.
- Peer-support programs and community-based education have shown improvements in lifestyle behaviors and some cardiovascular risk factors, although the reduction in diabetes incidence was not statistically significant.
Healthcare Professional and Organizational Interventions:
- Multifaceted professional interventions, including enhanced roles for nurses and structured patient reviews, have improved the process of care and patient outcomes .
- Quality improvement strategies involving nonphysician care coordinators and decision-support electronic health records have led to better achievement of diabetes care goals and improved cardiometabolic profiles.
Comprehensive Programs:
- Comprehensive programs like UDAY, which combine public health promotion, screening, patient education, and healthcare provider training, have shown promise in improving diabetes and hypertension management in both urban and rural settings.

Conclusion

Health interventions in India aimed at improving diabetes management have demonstrated varying degrees of success. Lifestyle interventions, particularly those involving yoga, exercise, and dietary education, have shown significant improvements in glycemic control and other health metrics. mHealth and peer-support programs have effectively improved health behaviors, though their impact on diabetes incidence is less clear. Multifaceted professional and organizational interventions have enhanced the process of care and patient outcomes. Comprehensive programs that integrate multiple strategies appear to be the most promising approach for managing diabetes in India.

Improvement of diabetes management from health intervention in India

Summary

Introduction

Key Insights

Conclusion

Sources and full results

Improving management of type 2 diabetes in South Asian patients: a systematic review of intervention studies

Diabetes management interventions targeted at South Asians living in Europe showed little improvement in HbA1c levels compared to usual care, but smaller studies in India showed significant improvements in glycemic and other end points.

Interventions to improve the management of diabetes in primary care, outpatient, and community settings: a systematic review.

Multifaceted professional interventions and organizational interventions, combined with patient education and enhanced nurse roles, effectively improve diabetes care process and patient outcomes.

mHealth Intervention to Improve Diabetes Risk Behaviors in India: A Prospective, Parallel Group Cohort Study

mDiabetes, a text messaging program, was feasible and showed initial evidence of effectiveness in improving diabetes-related health behaviors in India, but not exercise.

Improvement in diet habits, independent of physical activity helps to reduce incident diabetes among prediabetic Asian Indian men.

Lifestyle intervention, including diet and exercise, can reduce the risk of developing diabetes in Asian Indian men with impaired glucose tolerance.

A peer-support lifestyle intervention for preventing type 2 diabetes in India: A cluster-randomized controlled trial of the Kerala Diabetes Prevention Program

A low-cost community-based peer-support lifestyle intervention in India led to nonsignificant reduction in diabetes incidence but significant improvements in cardiovascular risk factors and physical functioning.

Effectiveness of a Multicomponent Quality Improvement Strategy to Improve Achievement of Diabetes Care Goals: A Randomized, Controlled Trial.

A multicomponent quality improvement strategy improves diabetes care goals and health-related quality of life in urban specialist clinics, even in resource-challenged settings.

UDAY: A comprehensive diabetes and hypertension prevention and management program in India

UDAY, a 5-year initiative in India, aims to improve diabetes and hypertension detection, prevention, and management by implementing a comprehensive intervention program in Sonipat and Visakhapatnam.

An endocrinologist-supported intervention aimed at providers improves diabetes management in a primary care site: improving primary care of African Americans with diabetes (IPCAAD) 7.

Feedback on performance given to primary care providers improves glycemic control in patients with type 2 diabetes, suggesting that partnering generalists with diabetes specialists may enhance diabetes management in other primary care settings.

Translating lifestyle intervention to practice in obese patients with type 2 diabetes: Improving Control with Activity and Nutrition (ICAN) study.

Moderate-cost dietitian-led lifestyle case management may improve diverse health indicators and quality of life for obese patients with type 2 diabetes compared to usual care.

Interventions to improve the management of diabetes mellitus in primary care, outpatient and community settings.

Multifaceted professional interventions, organizational interventions, and patient-oriented interventions can improve diabetes management in primary care, outpatient, and community settings.

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