Diabetics are at risk for a host of long-term complications including cerebrovascular accidents, myocardial infarctions, peripheral vascular insufficiency, blindness, and renal failure. Careful maintenance of a home care regimen for diabetics reduces the probability of long-term complications of the disease. Maintenance of the home regimen, however, can try the patience of the person with diabetes. When insulin is prescribed, diabetics must consider blood glucose effects of literally every decision they make in daily life. Coping with constant, ongoing demands for vigilance and self-discipline is often difficult and compliance to diabetes regimen is known to be low. Health care professionals must find effective ways to assist diabetics with regimen compliance in order to help them avoid long-term complications and associated disability, suffering, and expense. The proposed study will evaluate a low-cost intervention, self-help groups. Heath outcomes measured will be both physiological and psychological. Glycosylated hemoglobin will be measured to test metabolic control and a standardized measure of depression will be used for the psychological parameter. Subjects will be asked to join a group conducted by a diabetic lay leader who will be professionally supervised. The intervention groups will meet monthly for 8 months. Lay leaders will be required to attend a preparatory workshop and monthly leader meetings in addition to self-help group meetings. Study measures will be administered at baseline, 4 months, 8 months (completion of the group), and 12 months (4 months post-intervention). Subjects will serve as their own controls in this removed-treatment design. Data analysis will be accomplished by tests of bivariate correlation, repeated measures ANOVA, and multiple linear regression. Two undergraduates from the Department of Nursing will participate in the proposed project.
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