Telefonintervention bei Typ-2-Diabetikern

Zusammenfassung

Hintergrund und Fragestellung: Adipositas, Diabetes und die damit verbundenen Belastungen für das Gesundheitssystem nehmen in der westlichen Industriegesellschaft kontinuierlich zu. In verschiedenen Untersuchungen konnte durch Telefonintervention das Gesundheitsverhalten von Diabetikern verbessert werden.

Patienten und Methodik: Wir untersuchten die Auswirkung einer 3-monatigen Telefonintervention mit einem wöchentlichen Anruf auf Bewegungsverhalten und verschiedene kardiovaskuläre Risikofaktoren bei Patienten mit Diabetes mellitus Typ 2. Verglichen wurde eine Interventionsgruppe (n = 22) mit einer Kontrollgruppe (n = 19), die keine Anrufe erhielt.

Ergebnisse: Bewegungsverhalten und Aktivitätsumfang nahmen in der Interventionsgruppe deutlich zu, in der Kontrollgruppe kam es zu einer Abnahme beider Parameter.

Für Körpergewicht, Body-Mass-Index (BMI), Taillenumfang, Körperfett, systolischen und diastolischen Blutdruck, Triglyceride, HDL-, LDL- und Gesamtcholesterin kam es in der Interventionsgruppe zu stärkeren Verbesserungen als in der Kontrollgruppe.

Folgerung: Mittels einer wöchentlichen telefonischen Abfrage des Bewegungsverhaltens über 3 Monate kann gesundheitsbewusstes Verhalten gesteigert und das kardiovaskuläre Risikoprofil verbessert werden. Der Effekt bei längerfristiger Anwendung sowie Möglichkeit und Ausmaß einer Kostenersparnis für das Gesundheitssystem sollten überprüft werden.

Summary

Background and Objective: While there are evermore therapeutic options, a continuous rise in the prevalence of type 2 diabetes mellitus has been demonstrated in epidemiological studies and is leading to an increasing financial burden on health care systems. It has been shown in a number of studies that health-related lifestyle may be influenced by a telephone intervention program.

Patients and Methods: The effect of a telephone intervention on physical activity and other important cardiovascular risk factors was investigated over a period of three months in patients with type 2 diabetes. Those in the intervention group (n=22) were phoned once weekly and only matters concerning their physical activity were discussed. The patients in a matching control group (n=20) were not phoned.

Results: Physical activity increased in the intervention group with a significant difference when compared to the control group at the end of the three months' intervention. At the end of the intervention weight, body mass index, waist circumference, systolic blood pressure, triglycerides and fasting blood sugar where either significantly different between the intervention and control groups (absolute values) or showed a significantly greater decrease in the intervention group. In addition there was a tendency (not statistically significant) towards an improvement in the intervention group regarding other risk factors (body fat, diastolic blood pressure, total cholesterol, LDL, HDL, HbA1c).

Conclusions: These results demonstrate that a telephone intervention can increase physical activity and reduce cardiovascular risk factors. As a result it may reduce health care-related costs.

Diabetes - Adipositas - Hypertonie - Telefonintervention - Körperliche Aktivität - Kardiovaskuläre Risikofaktoren - Gesundheitssystem

diabetes - overweight - hypertension - telephone intervention - physical activity - cardiovascular risk factors - health care system

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