Quarterly individual outpatients lifestyle counseling after initial inpatients education on type 2 diabetes: The REDIA Prev-2 randomized controlled trial in Reunion Island

Aims. - This study aimed to describe the 1-year evolution of type 2 diabetes (T2D) patients who attended inpatients education, and to assess whether quarterly outpatients counseling visits by nurses and dietitians can improve metabolic control and health-related behaviours. Methods. - Following in-hospital educational sessions, 398 adult T2D patients were randomized to either attend quarterly individual lifestyle counseling visits by a nurse and a dietitian (intervention group), or receive the usual care (control group). Primary (HbA(1c)) and secondary endpoints (fasting blood glucose, lipids, body mass index, waist circumference, fat mass, blood pressure, diet, physical activity) were assessed at baseline and at 12 months. Results. - HbA(1c) changes from baseline to 12 months were -1.74 +/- 2.64% (P < 0.0001) for the intervention group and -2.02 +/- 2.57% (P < 0.0001) for the control group. There was no statistically significant difference between the intervention group (n = 153) and the controls (n = 166) for any of the clinical and biological outcomes. In both groups, total energy and fat intakes decreased significantly from baseline levels. Also, no difference was found between the groups for any dietary outcome. A slight enhancement in sports activity was observed in the intervention group, but the difference between the two groups did not reach statistical significance, and no difference was found concerning any other physical activity scores. Conclusion. - In this study of adults with T2D, patients significantly improved their metabolic control, and dietary and exercise habits, 1 year after receiving intensive inpatients education, whereas subsequent quarterly outpatients counseling visits with nurses and dietitians have not demonstrated any superiority compared with the usual care. (C) 2011 Elsevier Masson SAS. All rights reserved.