Is Telenursing an Effective Method to Control BMI and HbA1c in Illiterate Patients Aged 50 Years and Older With Type 2 Diabetes? A Randomized Controlled Clinical Trial

Introduction: Telenursing is a simple method to provide and maintain nursing care for patients with chronic illness such as diabetes. This study aimed to determine the effectiveness of telenursing on body mass index (BMI) and glycosylated hemoglobin (HbA1c) in illiterate patients aged 50 years and older with type 2diabetes.

Methods: A randomized controlled clinical trial was performed. Sixty patients with type 2 diabetes who referred to Aligoodarz diabetes clinic (Lorestan, Iran) were randomly assigned to the intervention and control group. Each patient was assessed before and after intervention for the following clinical parameters: HbA1c by Drew-DS5 analyzer and weight by scale (Sahand BMI electronic scale /Iran). All patients received diabetes self-care training for 3 days before the study. Telephone follow ups were applied in intervention group for 12 weeks. The data were analyzed using chi-square, paired t test and independent t test by SPSS11.

Results: Results showed statistically significant decrease in BMI at the end of the training from 29.28 (3.29) to 28.35 (3.37) kg/m2 and statistically significant decrease in HbA1c from 8.96 (1.24) to 7.56 (0.71) in the intervention group. The effect size base on Cohen’s formula for BMI and HbA1c was Cohen’s d=2.85, effect size r=0.81 and Cohen’s d=2.04, effect size r=0.71, respectively.

Conclusion: The findings indicate that nurse-led telephone follow up can increase adherence from treatment program and has beneficial effects on HbA1c and BMI in illiterate patients aged 50 years and older with type 2 diabetes.