Date of this Version
Eur Diabetes Nursing 2007; 4(2): 57–63.
Background: WISEWOMAN provides chronic disease risk factor screening, referrals and lifestyle interventions to low-income, uninsured women, to reduce their heart disease and stroke risk. Participants learn behaviour-changing skills tailored to low-income populations, such as collaborative goal setting, the need to take small steps and other empowerment techniques.
Aim: To quantify the baseline prevalence of pre-diabetes (fasting blood glucose 5.5–6.9 mmol/l) and diabetes among WISEWOMAN participants and assess one year changes in glucose levels and other diabetes risk factors.
Methods: We used 1998–2005 baseline and one-year follow-up data from WISEWOMAN participants. Using a multilevel regression model, we assessed one-year changes in glucose, blood pressure (BP), total cholesterol and 10-year risk of coronary heart disease (CHD) among participants with baseline pre-diabetes (n=688) or diabetes (n=338).
Results: At baseline, 15% of participants had pre-diabetes and 10% had diabetes. Of those with diabetes, 26% were unaware of their condition before baseline screening. During the one-year follow-up period, participants with pre-diabetes experienced statistically significant improvements in glucose (2.9%) and cholesterol (2.1%) levels and 10-year CHD risk (4.3%). Participants with newly diagnosed diabetes experienced statistically significant improvements in glucose (11.5%), BP (3.1%–3.5%) and cholesterol (6.4%) levels. Participants with previously diagnosed diabetes experienced significant improvements in BP (1.9–3.4%), cholesterol level (3.8%), and 10-year CHD risk (8.5%).
Conclusions: Implementing patient-centered, comprehensive and multilevel interventions and demonstrating their effectiveness will likely lead to the adoption of this approach on a much broader scale.