Skip to main content
Erschienen in: Wiener klinische Wochenschrift 1/2019

12.04.2019 | leitlinien für die praxis

Diabetesschulung und -beratung bei Erwachsenen mit Diabetes (Update 2019)

verfasst von: Raimund Weitgasser, Martin Clodi, Sarah Cvach, Michaela Riedl, Monika Lechleitner, Bernhard Ludvik

Erschienen in: Wiener klinische Wochenschrift | Sonderheft 1/2019

Einloggen, um Zugang zu erhalten

Zusammenfassung

Diabetesschulung und Selbstmanagement nehmen eine zentrale Rolle in der Diabetesbetreuung ein. Das dabei angestrebte Patientenempowerment zielt auf die aktive Beeinflussung des Diabetesverlaufs durch Selbstkontrolle und Therapieanpassung sowie die Befähigung der Betroffenen, den Diabetes in ihren Alltag zu integrieren und an ihre Lebensumstände entsprechend anzupassen. Eine Diabetesschulung ist allen Personen mit Diabetes zugänglich zu machen. Um ein strukturiertes und validiertes Schulungsprogramm anbieten zu können, sind adäquate personelle, räumliche, organisatorische und finanzielle Voraussetzungen zu schaffen. Neben dem Zuwachs an Wissen über die Erkrankung konnte gezeigt werden, dass eine strukturierte Diabetesschulung ergebnisorientiert Parameter wie Blutzucker, HbA1c, Blutdruck und Körpergewicht positiv beeinflussen kann. Neuere Schulungsmodelle betonen neben der Ernährung die körperliche Bewegung als wichtigen Bestandteil der Lebensstiltherapie und bedienen sich interaktiver Methoden, um die persönliche Verantwortung herauszuarbeiten. Spezifische Situationen (z. B. verminderte Hypoglykämieerkennung, Krankheit, Reisen) und technische Neuerungen wie Glukosesensorsysteme und Insulinpumpen bedürfen zusätzlicher Schulungsmaßnahmen durch Informationsaustausch in Kleingruppen, unterstützt durch adäquate elektronische Hilfsmittel (Diabetes-Apps, Diabetes-Web-Portale).
Literatur
2.
Zurück zum Zitat American Diabetes Association. Standards of medical care in diabetes—2018. Diabetes Care. 2018;41(Suppl.1):38–50.CrossRef American Diabetes Association. Standards of medical care in diabetes—2018. Diabetes Care. 2018;41(Suppl.1):38–50.CrossRef
4.
Zurück zum Zitat Ricci-Cabello I, Ruiz-Pérez I, Rojas-García A, Pastor G, Rodríguez-Barranco M, Gonçalves DC. Characteristics and effectiveness of diabetes self-management educational programs targeted to racial/ethnic minority groups: a systematic review, meta-analysis and meta-regression. Bmc Endocr Disord. 2014;14:60.CrossRef Ricci-Cabello I, Ruiz-Pérez I, Rojas-García A, Pastor G, Rodríguez-Barranco M, Gonçalves DC. Characteristics and effectiveness of diabetes self-management educational programs targeted to racial/ethnic minority groups: a systematic review, meta-analysis and meta-regression. Bmc Endocr Disord. 2014;14:60.CrossRef
5.
Zurück zum Zitat Jones V, Crowe M. How people from ethnic minorities describe their experiences of managing type-2 diabetes mellitus: a qualitative meta-synthesis. Int J Nurs Stud. 2017;76:78–91.CrossRef Jones V, Crowe M. How people from ethnic minorities describe their experiences of managing type-2 diabetes mellitus: a qualitative meta-synthesis. Int J Nurs Stud. 2017;76:78–91.CrossRef
6.
Zurück zum Zitat Sperl-Hillen J, Beaton S, Fernandes O, et al. Comparative effectiveness of patient education methods for type 2 diabetes: a randomised controlled trial. Arch Intern Med. 2011;171:2001–10.CrossRef Sperl-Hillen J, Beaton S, Fernandes O, et al. Comparative effectiveness of patient education methods for type 2 diabetes: a randomised controlled trial. Arch Intern Med. 2011;171:2001–10.CrossRef
7.
Zurück zum Zitat Srulovici E, Key C, Rotem M, Golfenshtein N, Balicer RD, Shadmi E. Diabetes conversation map™ and health outcomes: a systematic literature review. Int J Nurs Stud. 2017;70:99–109.CrossRef Srulovici E, Key C, Rotem M, Golfenshtein N, Balicer RD, Shadmi E. Diabetes conversation map™ and health outcomes: a systematic literature review. Int J Nurs Stud. 2017;70:99–109.CrossRef
8.
Zurück zum Zitat Creamer J, Attridge M, Ramsden M, Cannings-John R, Hawthorne K. Culturally appropriate health education for type 2 diabetes in ethnic minority groups: an updated Cochrane Review of randomized controlled trials. Diabet Med. 2016;33(2):169–83.CrossRef Creamer J, Attridge M, Ramsden M, Cannings-John R, Hawthorne K. Culturally appropriate health education for type 2 diabetes in ethnic minority groups: an updated Cochrane Review of randomized controlled trials. Diabet Med. 2016;33(2):169–83.CrossRef
10.
Zurück zum Zitat Gehr B, Holder M, Kulzer B, Lange K, Liebl A, Sahm C, von Sengbusch S, Schlüter S, Siegmund T, Thurm U, Ziegler R, Freckmann G, Heinemann L, SPECTRUM Group. SPECTRUM. J Diabetes Sci Technol. 2017;11(2):284–9.CrossRef Gehr B, Holder M, Kulzer B, Lange K, Liebl A, Sahm C, von Sengbusch S, Schlüter S, Siegmund T, Thurm U, Ziegler R, Freckmann G, Heinemann L, SPECTRUM Group. SPECTRUM. J Diabetes Sci Technol. 2017;11(2):284–9.CrossRef
11.
Zurück zum Zitat Hou C, Xu Q, Diao S, Hewitt J, Li J, Carter B. Mobile phone applications and self-management of diabetes: a systematic review with meta-analysis, meta-regression of 21 randomized trials, and GRADE. Diabetes Obes Metab. 2018;20(8):2009–2013.CrossRef Hou C, Xu Q, Diao S, Hewitt J, Li J, Carter B. Mobile phone applications and self-management of diabetes: a systematic review with meta-analysis, meta-regression of 21 randomized trials, and GRADE. Diabetes Obes Metab. 2018;20(8):2009–2013.CrossRef
12.
Zurück zum Zitat Bonoto BC, de Araújo VE, Godói IP, de Lemos LL, Godman B, Bennie M, Diniz LM, Junior AA. Efficacy of mobile Apps to support the care of patients with diabetes mellitus: a systematic review and Meta-analysis of randomized controlled trials. JMIR Mhealth Uhealth. 2017;5(3):e4.CrossRef Bonoto BC, de Araújo VE, Godói IP, de Lemos LL, Godman B, Bennie M, Diniz LM, Junior AA. Efficacy of mobile Apps to support the care of patients with diabetes mellitus: a systematic review and Meta-analysis of randomized controlled trials. JMIR Mhealth Uhealth. 2017;5(3):e4.CrossRef
13.
Zurück zum Zitat Heitkemper EM, Mamykina L, Travers J, Smaldone A. Do health information technology self-management interventions improve glycemic control in medically underserved adults with diabetes? A systematic review and meta-analysis. J Am Med Inform Assoc. 2017;24(5):1024–35.CrossRef Heitkemper EM, Mamykina L, Travers J, Smaldone A. Do health information technology self-management interventions improve glycemic control in medically underserved adults with diabetes? A systematic review and meta-analysis. J Am Med Inform Assoc. 2017;24(5):1024–35.CrossRef
14.
Zurück zum Zitat Song Y, Nam S, Park S, Shin IS, Ku BJ. The impact of social support on self-care of patients with diabetes: what is the effect of diabetes type? Systematic review and meta-analysis. Diabetes Educ. 2017;43(4):396–412.CrossRef Song Y, Nam S, Park S, Shin IS, Ku BJ. The impact of social support on self-care of patients with diabetes: what is the effect of diabetes type? Systematic review and meta-analysis. Diabetes Educ. 2017;43(4):396–412.CrossRef
15.
Zurück zum Zitat Cheng L, Sit JW, Choi KC, Chair SY, Li X, He XL. Effectiveness of interactive self-management interventions in individuals with poorly controlled type 2 diabetes: a Meta-analysis of randomized controlled trials. Worldviews Evid Based Nurs. 2017;14(1):65–73.CrossRef Cheng L, Sit JW, Choi KC, Chair SY, Li X, He XL. Effectiveness of interactive self-management interventions in individuals with poorly controlled type 2 diabetes: a Meta-analysis of randomized controlled trials. Worldviews Evid Based Nurs. 2017;14(1):65–73.CrossRef
16.
Zurück zum Zitat Doshmangir P, Jahangiry L, Farhangi MA, Doshmangir L, Faraji L. The effectiveness of theory- and model-based lifestyle interventions on HbA1c among patients with type 2 diabetes: a systematic review and meta-analysis. Public Health. 2018;155:133–41.CrossRef Doshmangir P, Jahangiry L, Farhangi MA, Doshmangir L, Faraji L. The effectiveness of theory- and model-based lifestyle interventions on HbA1c among patients with type 2 diabetes: a systematic review and meta-analysis. Public Health. 2018;155:133–41.CrossRef
17.
Zurück zum Zitat Tricco AC, Ivers NM, Grimshaw JM, et al. Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis. Lancet. 2012;379:2252–61.CrossRef Tricco AC, Ivers NM, Grimshaw JM, et al. Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis. Lancet. 2012;379:2252–61.CrossRef
19.
Zurück zum Zitat Deakin T, McShane CE, Cade JE, Williams RD. Group-based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005;2:CD3417. Deakin T, McShane CE, Cade JE, Williams RD. Group-based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005;2:CD3417.
20.
Zurück zum Zitat Chatterjee S, Davies MJ, Heller S, Speight J, Snoek FJ, Khunti K. Diabetes structured self-management education programmes: a narrative review and current innovations. Lancet Diabetes Endocrinol. 2018;6(2):130–42.CrossRef Chatterjee S, Davies MJ, Heller S, Speight J, Snoek FJ, Khunti K. Diabetes structured self-management education programmes: a narrative review and current innovations. Lancet Diabetes Endocrinol. 2018;6(2):130–42.CrossRef
21.
Zurück zum Zitat Warsi A, Wang PS, LaValley MP, et al. Self-management education programs in chronic disease. A systematic review and methodological critique of the literature. Arch Intern Med. 2004;164:1641–9.CrossRef Warsi A, Wang PS, LaValley MP, et al. Self-management education programs in chronic disease. A systematic review and methodological critique of the literature. Arch Intern Med. 2004;164:1641–9.CrossRef
22.
Zurück zum Zitat White RD. Patient empowerment and optimal glycemic control. Curr Med Res Opin. 2012;28(6):979–89. Mar 19, epub ahead of print.CrossRef White RD. Patient empowerment and optimal glycemic control. Curr Med Res Opin. 2012;28(6):979–89. Mar 19, epub ahead of print.CrossRef
23.
Zurück zum Zitat Ofman JJ, Badamgarav E, Henning JM, et al. Does disease management improve clinical and economic outcomes in patients with chronic diseases? A systematic review. Am J Med. 2004;117:182–92.CrossRef Ofman JJ, Badamgarav E, Henning JM, et al. Does disease management improve clinical and economic outcomes in patients with chronic diseases? A systematic review. Am J Med. 2004;117:182–92.CrossRef
24.
Zurück zum Zitat Reynolds R, Dennis S, Hasan I, Slewa J, Chen W, Tian D, Bobba S, Zwar N. A systematic review of chronic disease management interventions in primary care. Bmc Fam Pract. 2018;19(1):11.CrossRef Reynolds R, Dennis S, Hasan I, Slewa J, Chen W, Tian D, Bobba S, Zwar N. A systematic review of chronic disease management interventions in primary care. Bmc Fam Pract. 2018;19(1):11.CrossRef
25.
Zurück zum Zitat Qi L, Liu Q, Qi X, et al. Effectiveness of peer support for improving glycaemic control in patients with type 2 diabetes: a meta-analysis of randomized controlled trials. BMC Public Health. 2015;15:471. May 6, published online.CrossRef Qi L, Liu Q, Qi X, et al. Effectiveness of peer support for improving glycaemic control in patients with type 2 diabetes: a meta-analysis of randomized controlled trials. BMC Public Health. 2015;15:471. May 6, published online.CrossRef
26.
Zurück zum Zitat Patil SJ, Ruppar T, Koopman RJ, Lindbloom EJ, Elliott SG, Mehr DR, Conn VS. Effect of peer support interventions on cardiovascular disease risk factors in adults with diabetes: a systematic review and meta-analysis. BMC Public Health. 2018;18(1):398.CrossRef Patil SJ, Ruppar T, Koopman RJ, Lindbloom EJ, Elliott SG, Mehr DR, Conn VS. Effect of peer support interventions on cardiovascular disease risk factors in adults with diabetes: a systematic review and meta-analysis. BMC Public Health. 2018;18(1):398.CrossRef
Metadaten
Titel
Diabetesschulung und -beratung bei Erwachsenen mit Diabetes (Update 2019)
verfasst von
Raimund Weitgasser
Martin Clodi
Sarah Cvach
Michaela Riedl
Monika Lechleitner
Bernhard Ludvik
Publikationsdatum
12.04.2019
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe Sonderheft 1/2019
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-019-1449-x

Weitere Artikel der Sonderheft 1/2019

Wiener klinische Wochenschrift 1/2019 Zur Ausgabe