RESUMO
Background: Incentives play a role in introducing health-related benefits, but no interventions using mixed incentives, i.e. a combination of individual and group incentives, have been tested in individuals with type 2 diabetes mellitus (T2DM). We evaluated the feasibility of implementing individual- and mixed-incentives, with and without a supportive partner, on glycated haemoglobin (HbA1c) control and weight loss among patients with T2DM. Methods: This is a feasibility, sex-stratified, single-blinded, randomized controlled study in individuals with T2DM. All participants received diabetes education and tailored goal setting for weight and glycated haemoglobin (HbA1c). Participants were randomly assigned into three arms: individual incentives (Arm 1), mixed incentives-altruism (Arm 2), and mixed incentives-cooperation (Arm 3). Participants were accompanied by a diabetes educator every other week to monitor targets, and the intervention period lasted 3 months. The primary outcome was the change in HbA1c at 3 months from baseline. Weight and change body mass index (BMI) were considered as secondary outcomes. Results: Out of 783 patients screened, a total of 54 participants, 18 per study arm, were enrolled and 44 (82%) completed the 3-month follow-up. Mean baseline HbA1c values were 8.5%, 7.9% and 8.2% in Arm 1, Arm 2, and Arm 3, respectively. At 3 months, participants in all three study arms showed reductions in HbA1c ranging from -0.9% in Arm 2 to -1.4% in Arm 1. Weight and BMI also showed reductions. Conclusions: Individual and mixed cash incentives show important reductions in HbA1c, weight and BMI in patients with type 2 diabetes mellitus after 3 months. Recruitment and uptake of the intervention were successfully accomplished demonstrating feasibility to conduct larger effectiveness studies to test individual and mixed economic incentives for diabetes management. Registration: ClinicalTrials.gov Identifier NCT02891382.
RESUMO
Conocer la prevalencia de la diabetes mellitus y sus factores de riesgo en una población urbana de Lima ciudad. Material y métodos. Se realizó un estudio transversal descriptivo, aleatorio y por conglomerados a 213 sujetos mayores de 15 años del distrito de Breña, en Lima ciudad. Se registró los valores de presión arterial, peso, talla, medición de cintura, glicemia basal, colesterol y triglicéridos. Resultados. Se encontró: una prevalencia de diabetes mellitus de 7, 04 por ciento (IC95 por ciento : 3,60 por ciento- 10, 48 por ciento); intolerancia a los carbohidratos de 2,82 por ciento (IC95 por ciento : 29, 70 por ciento- 42, 60 por ciento); hipercolesterolemia 19,25 por ciento (IC95 por ciento : 3,96 por ciento- 24, 54 por ciento); hipertrigliceridemia 27, 70 por ciento (IC95 por ciento : 21, 69- 33, 71 por ciento) ; obesidad 21, 60 por ciento (IC95 por ciento (IC95 por ciento : 16, 07 por ciento - 27, 13 por ciento) sobrepeso 37, 56 por ciento (IC95 por ciento : 26, 11 por ciento- 38, 68 por ciento) y consumo de bebidas alcohólicas 62, 44 por ciento (IC95 por ciento : 55, 94 por ciento- 68, 94 por ciento ). Conclusiones. Se encontró un prevalencia relativamente alta (7, 04 por ciento) de diabetes mellitus en el distrito de Breña en Lima ciudad. Los factores de riesgo relacionados a la diabetes fueron baja actividad física, sobrepeso, hipertensión arterial y obesidad.
