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Consumer Summary – Nov. 29, 2016

Behavioral Programs To Help Manage Type 2 Diabetes: A Review of the Research for Adults

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Is This Information Right For Me?

This summary is for you if your health care professional has said you have type 2 diabetes. This summary will tell you what researchers have found about behavioral programs to help manage type 2 diabetes. It does not cover specific treatments for diabetes.

What Is Type 2 Diabetes?

Diabetes (also called "diabetes mellitus") is a condition in which your body has trouble controlling the level of sugar (or glucose) in your blood. Insulin is a hormone that your body needs to use the sugar for energy. If you have type 2 diabetes, your body cannot use insulin well and may not make enough insulin. Having low insulin causes sugar to build up in your blood, and your blood sugar level gets too high.

It is important to manage diabetes because high blood sugar can cause serious health issues over time. Your health care professional can help you make a plan to manage your diabetes. Your health care professional may also suggest a behavioral program to help you learn how to manage your diabetes.

How Is Type 2 Diabetes Managed?

You can manage the effects of diabetes on your health by trying to keep your blood sugar level within a healthy range. Your health care professional can help you set a goal for your blood sugar level and make a plan to manage your diabetes.

People with type 2 diabetes are often able to manage their diabetes by changing their diet, being more physically active, maintaining a healthy weight, and taking diabetes medicines. Some people with type 2 diabetes may also need to take insulin shots.

It is important to follow your management plan every day.

What Are Behavioral Programs for Diabetes?

In behavioral programs for diabetes, a trained provider helps you learn to manage your diabetes. Some behavioral programs are one-on-one. Some are done in a group. The program may be done in person, on the phone, or online. The trained provider may be a health care professional, such as a nurse, pharmacist, or dietitian. Or, the trained provider may be a person who is not a health care professional but is trained to provide behavioral programs for diabetes.

There are several types of behavioral programs for diabetes, including:

  • Diabetes self-management education. This type of program is focused on education about diabetes, the disease process, and treatment. A trained provider can help you learn how to manage your diabetes as part of your daily life. He or she can also help you set specific goals to manage your diabetes on your own. You will likely meet with the provider one or more times a week for at least a month. A trained provider may continue to support you after the program ends.
  • Lifestyle programs. In this type of program, a trained provider helps you learn how to make specific lifestyle changes to help you manage your diabetes. Lifestyle changes can help lower the risk of health issues from diabetes. Lifestyle programs may focus on diet, physical activity, or both.
    • Dietary program: Teaches you how to eat a healthy diet in order to lose weight, manage your blood sugar, and lower your risk of health issues from diabetes.
    • Physical activity program: Teaches you how to do the right amount and the right types of physical activity. Some types of physical activity make your heart beat fast. Other types help strengthen your bones and muscles.

A behavioral program for diabetes can help you:

  • Learn more about diabetes and how to follow your management plan
  • Set goals and learn problem-solving skills to help manage your diabetes
  • Develop healthy behaviors, such as eating a healthy diet and being active
  • Learn how to maintain a healthy weight
  • Learn how to check your blood sugar (if needed) and take your medicines correctly
  • Take steps to lower your risk for health issues from diabetes (see the section below for more information about possible health issues from diabetes)

The trained provider may also talk with you about:

  • Signs of health issues from diabetes
  • Yearly tests to check for any health issues from diabetes (such as a urine test to check for kidney damage, a foot exam, and an eye exam)
  • How to cope with stress related to living with diabetes

What Have Researchers Found?

Researchers found the following about behavioral programs for people with type 2 diabetes:

  • Behavioral programs helped people with type 2 diabetes manage their diabetes.
  • Diabetes self-management education programs that worked best:
    • Included 11 or more hours of meeting time with the trained provider.
    • Often included continued support after the program ended.
  • Behavioral programs that had some in-person meetings worked better than programs done only over the phone or online.
  • Lifestyle programs focused on diet or physical activity worked best to lower body mass index (BMI). Body mass index is a measurement based on your height and weight that helps your health care professional check if you are at a healthy weight.

Why Is It Important To Manage Type 2 Diabetes?

It is important for people with type 2 diabetes to try to keep their blood sugar level within a healthy range.

Having high blood sugar (a condition called "hyperglycemia") can cause serious health issues in the long term. These may include:

  • Heart disease and heart attack
  • Stroke
  • Kidney problems
  • Eye problems and possibly blindness
  • Nerve damage
  • Foot problems, which in severe cases may lead to amputation (loss) of the foot

It is also important to watch for signs that your blood sugar is too low (a condition called "hypoglycemia"). If your blood sugar gets too low, you may suddenly feel weak, become dizzy, or faint. If not treated right away, hypoglycemia can be life threatening.

When your blood sugar level is within a healthy range, you are likely to:

  • Feel less tired and have more energy
  • Heal better and have fewer skin infections
  • Feel less thirsty, need to urinate less often, and have fewer bladder infections

Talking With Your Health Care Professional

You may want to ask your health care professional:

  • How could a behavioral program help me manage my type 2 diabetes?
  • How do I sign up for a behavioral program?
  • How often and for how many months would I need to meet with the trained provider?
  • How long would each program session be?
  • Would my insurance cover the cost of the behavioral program?
  • Will I follow up with you after finishing the behavioral program?

Source

The information in this summary comes from Pillay J, Chordiya P, Dhakal S, Vandermeer B, Hartling L, Armstrong MJ, Butalia S, Donovan LE, Sigal RJ, Featherstone R, Nuspl M, Dryden DM. Behavioral Programs for Diabetes Mellitus. Evidence Report/Technology Assessment No. 221. (Prepared by the University of Alberta Evidence-based Practice Center under Contract No. 290-2012-00013-I.) AHRQ Publication No. 15-E003-EF. Rockville, MD: Agency for Healthcare Research and Quality; September 2015.

Additional information came from the MedlinePlus® Web site, a service of the National Library of Medicine and the National Institutes of Health.

This summary was prepared by the John M. Eisenberg Center for Clinical Decisions and Communications Science at Baylor College of Medicine, Houston, TX. It was written by Amelia Williamson Smith, M.S., Stephen Martin, M.D., Frank Domino, M.D., and Michael Fordis, M.D. People with type 2 diabetes gave feedback on this summary.