Diabetes intervention in Västerbotten, part 1-3

Research project DIVA 1-3 are intervention studies in primary care directed to people with type 2 diabetes. Person-centered group support and individual support is included. DIVA 1-2 are RCTs while DIVA 3 is a case-control study with pre and post measurements.

DIVA 1. Completed RCT study in primary care directed to people with type 2 diabetes, which includes an intervention consisting of person-centered support group, 10 meetings. Good effects reported at one and five year follow-up. DIVA 2. Ongoing RCT study in primary care directed to people with type 2 diabetes, which includes an intervention consisting of person-centered self-management support, here reduced to six meetings in groups or individually. Good effects reported at one-year follow-up. DIVA 3. An implementation study in Östergötland and Sörmland with five group meetings. One-year follow-up data is collected in 2016 .

Head of project

Åsa Hörnsten Professor

+46 90 786 91 59

Project overview

Project period:

2001-01-01 – 2017-12-31

Participating departments and units at Umeå University

Department of Nursing

Research subject

Public health and health care science

Project members

Berit Lundman Professor emerita

Email

+46 90 786 92 54

Ulf Isaksson Associate professor

Email

+46 90 786 91 86

Lena Jutterström Associate professor, combined with clinical employment

Email

+46 90 786 63 84

Eva Boström Associate professor

Email

+46 90 786 92 70

Project description

In English
DIVA 1. Completed randomized trial in primary care directed to people with type 2 diabetes which included an intervention consisting of person-centered support group at 10 meetings. Good effects are reported in Hörnsten doctoral thesis from 2004, among other publications. The intervention group (n = 44) were interviewed about their personal understandings of illness and then participated in support group meetings at 4 health centers led by Hörnsten. A one-year follow-up showed that the intervention group compared to the control group (n= 60) improved their HbA1c and the difference between the groups was 1 percentage unit in HbA1c. A five-year follow-up showed that the difference between the groups had increased to 1.37 percentages, something SBU has evaluated as equivalent to insertion of oral treatment.

DIVA 2. Ongoing randomized trial in primary care directed to people with type 2 diabetes which included an intervention consisting of person-centered self-management support, now reduced to six meetings in groups or individually. Good effects are reported in Jutterström’s and Boström’s dissertations from 2013, among other publications. In the intervention study, 131 people were randomized to either support group (n=63), individual support (n=34) or an internal control group (n=34). The support was led by the diabetes nurses at nine participating health centers. Furthermore, an external control group (n=51) from another county was added to control so-called spillover effects. A one-year follow-up showed that both groups support that individual support had good effect and reduced HbA1c by 5 respective 4 mmol/mol. The difference between the support group and the external control group was 7 mmol/mol, which is comparable with the effects from insertion of oral treatment. A five-year follow-up is planned.

DIVA 3. An implementation study in parts of Östergötland and Sörmland similar to the DIVA 2, but only group support was offered, led by diabetes nurses in the health care centers. The meetings were reduced to five. More than 200 participants were invited to participate. Data from a one-year follow-up is collected in 2016 . The study will be implemented on a larger scale if good results from the follow-up are presented