The da Vinci Medical-mental motivation program for supporting lifestyle changes in patients with type 2 diabetes [Medizinisch-mentales Motivationstraining Da Vinci zur Unterstützung einer Lebensstilumstellung bei Typ-2-Diabetes]

摘要

Background and objective: Healthy diet and physical activity can improve metabolic control in patients with type 2 diabetes mellitus. However, lifestyle change without external help is difficult: an alteration of mental attitude is necessary to achieve long-term success. A computer-based motivational program (Da Vinci") has been developed to help patients to change their mental attitudes and beliefs. Methods: Patients with type 2 diabetes were supervised by psychological trainers in four sessions at ten study centers. The interactive computer program allowed for identification of motivation restraints and overcoming them. Parameters of carbohydrate metabolism were measured at the beginning and end of the three-months program as well as three and six months after end of program. Results: All participants (n=61) developed a positive attitude towards the range of their action and by themselves changed their lifestyle. After three months their weight (-4.6 kg; p0.0001), body mass index (-1.1kg/m 2; p0.0001), waist circumference (-3.5 cm; p0.0001), HbA1c (-0.6%; p0.0001), triglycerides (-31.1mg/dl; p=0.033), systolic (-4.0 mmHg; p=0.005) and diastolic blood pressure (-3.0 mmHg; p=0.006) had been reduced. Short duration of diabetes and high baseline HbA1c values were predictive for successful HbA1c reduction. Three and six months after end of the program participants were able to maintain or even augment achieved improvements. Conclusion: During the motivational program, which is intended to alter mental attitude and beliefs, but not to teach knowledge about diabetes, participants were able to significantly improve their metabolic control. As these improvements were maintained long-term, this points to sustainable lifestyle change.