Key result
The Meta Salud Diabetes intervention reduced Framingham CVD risk scores by 3.17% age-points compared to usual care at 3 months (95% CI -5.60 to -0.75; P=0.013).
Why the study?
Healthy lifestyle interventions in support groups may improve chronic disease management, prompting assessment of an educational intervention in type 2 diabetes support groups to reduce cardiovascular disease risk.
Does a 13-week educational intervention (Meta Salud Diabetes) reduce Framingham CVD risk scores and hypertension in patients with type 2 diabetes?
RCT (n=518)
cluster-randomized
Yes
Does a 13-week educational intervention (Meta Salud Diabetes) reduce Framingham CVD risk scores and hypertension in patients with type 2 diabetes?
Mean Difference: -3.17 (95% CI -5.6–-0.75)
p-value: p=0.013
A 13-week educational intervention in type 2 diabetes support groups significantly reduced Framingham CVD risk scores at 3 months, though the effect attenuated by 12 months.
May warrant short-term educational programs in T2D; extends RCT evidence on CVD risk reduction while leaving durability open.
BACKGROUND: Healthy lifestyle interventions offered at points of care, including support groups, may improve chronic disease management, especially in low-resource populations. We assessed the effectiveness of an educational intervention in type 2 diabetes (T2D) support groups to reduce cardiovascular disease (CVD) risk. METHODS: We recruited 518 participants to a parallel, two-arm, cluster-randomized, behavioural clinical trial across 22 clinics in Sonora, Mexico, between August 2016 and October 2018. We delivered a 13-week secondary prevention intervention, Meta Salud Diabetes (MSD), within the structure of a support group (GAM: Grupo de Ayuda Mutua) in government-run (community) Health Centres (Centros de Salud). The primary study outcomes were difference in Framingham CVD risk scores and hypertension between intervention (GAM+MSD) and control (GAM usual care) arms at 3 and 12 months. RESULTS: CVD risk was 3.17% age-points lower in the MSD arm versus control at 3 months [95% confidence interval (CI): -5.60, -0.75, P = 0.013); at 12 months the difference was 2.13% age-points (95% CI: -4.60, 0.34, P = 0.088). There was no evidence of a difference in hypertension rates between arms. Diabetes distress was also lower at 3 and 12 months in the MSD arm. Post-hoc analyses showed greater CVD risk reduction among men than women and among participants with HbA1c < 8. CONCLUSIONS: MSD contributed to a positive trend in reducing CVD risk in a low-resource setting. This study introduced an evidence-based curriculum that provides T2D self-management strategies for those with controlled T2D (i.e. HbA1c < 8.0) and may improve quality of life.
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Rosales et al. (2021) conducted an RCT in type 2 diabetes (n=518). Meta Salud Diabetes (MSD) vs. usual care was evaluated on difference in Framingham CVD risk scores and hypertension (MD -3.17% age-points, 95% CI -5.60, -0.75, p=0.013). The Meta Salud Diabetes intervention reduced Framingham CVD risk scores by 3.17% age-points compared to usual care at 3 months (95% CI -5.60 to -0.75; P=0.013).
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