It is also likely that reduction in total and abdominal
weight combined with other components of the structured
intervention helped patients participating in the intervention
arm achieve improvements in glycemic and metabolic
control. An integrated approach to diabetes management
such as that used in the present study can have a
substantial impact on awareness and behavior and thus
control of the metabolic condition. For example, a recent
study in adult subjects who were predominantly T2DM
conducted in the U.S. showed that the gain in knowledge
of the targets of diabetes care after receiving diabetes selfmanagement
education can predict the achievement of
target HbA1c levels after 6 months.18 The authors concluded
that the education improved patients’ understanding
of the importance of reaching the targets, thus motivated
them to adopt better self-management practices
leading to better glycemic control. During the time this
current study was conducted, home blood glucose monitoring
was not a common practice (Dr. Wang, personal
communication, September, 2007). A review of study
records showed that subjects in the Intervention Group
increased self-monitoring of blood glucose throughout the
24-week intervention period. An increase in the frequency
of blood glucose testing in the group that received glucose
monitors no doubt contributed to a greater awareness of
the impact of their daily behaviors on their blood glucose,
thus leading to important changes to enable better control
of their condition.