DESMOND (Diabetes Education and Self-Management for the Ongoing and Newly Diagnosed): Is it only for the newly diagnosed? — ASN Events

DESMOND (Diabetes Education and Self-Management for the Ongoing and Newly Diagnosed): Is it only for the newly diagnosed? (#74)

Sophie McGough 1 , Emma Adams 1 , Debbie Schofield 1 , Kylie Mahoney 1 , Helen Mitchell 1 , Timothy Skinner 2
  1. Diabetes WA, Subiaco, WA, Australia
  2. School of Psychological and Clinical Sciences, Charles Darwin University, Darwin, Northern Territory, Australia

Background

DESMOND (Diabetes Education Self-Management for the On-Going and Newly Diagnosed) is a one day program for people with type two diabetes (1). Previous trials using a newly diagnosed cohort found significant clinical, behavioural and psychosocial outcomes, including a significant reduction in diabetes distress (1). An adapted DESMOND curriculum (DESMOND Foundation) for those diagnosed for more than 12 months was developed, but no data exists on the outcomes of DESMOND in this target group.

Aim

To investigate the impact of the DESMOND Foundation program on diabetes distress in participants diagnosed with type two diabetes for more than 12 months.

Method

Participants attended a one day DESMOND Foundation program. Diabetes distress was assessed pre-post using the Problem Areas in Diabetes Scale (PAID). PAID item scores were summed and compared using Related-Samples Wilcoxon Signed Rank Test. A higher PAID score indicates a higher level of diabetes distress. Individual PAID items were compared for changes in the proportion of participants with scores of zero or one.

Results

There was a significant decrease in the median PAID score from 20.0 at pre to 11.0 at post (n=37; p=0.001). For five of the PAID items, the proportion of participants with a score of zero or one increased by 50% or more: not having clear goals, feeling discouraged with treatment plan, worrying about low blood sugar, feeling concerned about food and eating, worrying about future and serious complications, and feelings of guilt or anxiety.

Discussion

DESMOND Foundation significantly reduced perceived diabetes distress in this sample group. The underlying theories behind DESMOND have a strong focus on action planning, the impact of which can be seen in the changes for individual PAID items. These results provide preliminary data that the DESMOND Foundation program may achieve similar psychosocial outcomes to those attending the newly diagnosed program.

  1. Davies MJ, Heller S, Skinner TC, Campbell MJ, Carey ME, Cradock S, et al. Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial. BMJ. 2008;336(7642):491-5.
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