PMID- 23735726
OWN - NLM
STAT- MEDLINE
DCOM- 20140421
LR  - 20220409
IS  - 1935-5548 (Electronic)
IS  - 0149-5992 (Print)
IS  - 0149-5992 (Linking)
VI  - 36
IP  - 9
DP  - 2013 Sep
TI  - REDEEM: a pragmatic trial to reduce diabetes distress.
PG  - 2551-8
LID - 10.2337/dc12-2493 [doi]
AB  - OBJECTIVE: To compare three interventions to reduce diabetes distress (DD) and 
      improve self-management among non-clinically depressed adults with type 2 
      diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: In REDEEM, 392 adults with 
      T2DM and DD were randomized to computer-assisted self-management (CASM), CASM 
      plus DD-specific problem solving (CAPS), or a computer-administered minimal 
      supportive intervention. Primary outcomes were Diabetes Distress Scale (DDS) 
      total, the Emotional Burden (EB) and Regimen Distress (RD) DDS subscales, and 
      diet, exercise, and medication adherence. RESULTS: Significant and clinically 
      meaningful reductions in DD (DDS, EB, and RD) and self-management behaviors 
      occurred in all three conditions (P < 0.001), with no significant between-group 
      differences. There was, however, a significant group x baseline distress 
      interaction (P < 0.02), in which patients with high baseline RD in the CAPS 
      condition displayed significantly larger RD reductions than those in the other 
      two conditions. RD generated the most distress and displayed the greatest 
      distress reduction as a result of intervention. The pace of DD reduction varied 
      by patient age: older patients demonstrated significant reductions in DD early in 
      the intervention, whereas younger adults displayed similar reductions later. 
      Reductions in DD were accompanied by significant improvements in healthy eating, 
      physical activity, and medication adherence, although not by change in HbA1c. 
      CONCLUSIONS: DD is malleable and highly responsive to intervention. Interventions 
      that enhance self-management also reduce DD significantly, but DD-specific 
      interventions may be necessary for patients with high initial levels of DD. 
      Future research should identify the minimal, most cost-effective interventions to 
      reduce DD and improve self-management.
FAU - Fisher, Lawrence
AU  - Fisher L
AD  - University of California, San Francisco, San Francisco, California, USA. 
      fisherl@fcm.ucsf.edu
FAU - Hessler, Danielle
AU  - Hessler D
FAU - Glasgow, Russell E
AU  - Glasgow RE
FAU - Arean, Patricia A
AU  - Arean PA
FAU - Masharani, Umesh
AU  - Masharani U
FAU - Naranjo, Diana
AU  - Naranjo D
FAU - Strycker, Lisa A
AU  - Strycker LA
LA  - eng
SI  - ClinicalTrials.gov/NCT00714441
GR  - P30 DK063720/DK/NIDDK NIH HHS/United States
GR  - R01 DK061937/DK/NIDDK NIH HHS/United States
GR  - DK061937/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20130604
PL  - United States
TA  - Diabetes Care
JT  - Diabetes care
JID - 7805975
SB  - IM
MH  - Adult
MH  - Aged
MH  - Diabetes Mellitus, Type 2/*psychology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Self Care/*methods
MH  - Young Adult
PMC - PMC3747867
EDAT- 2013/06/06 06:00
MHDA- 2014/04/22 06:00
PMCR- 2014/09/01
CRDT- 2013/06/06 06:00
PHST- 2013/06/06 06:00 [entrez]
PHST- 2013/06/06 06:00 [pubmed]
PHST- 2014/04/22 06:00 [medline]
PHST- 2014/09/01 00:00 [pmc-release]
AID - dc12-2493 [pii]
AID - 2493 [pii]
AID - 10.2337/dc12-2493 [doi]
PST - ppublish
SO  - Diabetes Care. 2013 Sep;36(9):2551-8. doi: 10.2337/dc12-2493. Epub 2013 Jun 4.