A Model Clinical Program for Patients With Diabetes and Vision Impairment

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Abstract
A program was developed to improve independence, self- esteem, and glycemic control in patients with diabetes and blindness. Twenty-nine individuals with both insulin- dependent and noninsulin dependent diabetes mellitus entered 12-week programs that included education focusing on diabetes self-management skills for the visually impaired, monitored exercise sessions, and group support. Glycated. hemoglobin valuesfellfrom 13.0% ± 0.6% (SEM) to 11.4% ± 0.5% (P=.001). Exercise tolerance in a 12-minute walk test improved from 0. 48 ± 0. 04 to 0. 64 ± 0.05 miles (P=.001). Marked improvements occurred in psychosocial indices, demonstrated through changes in the Rand Mental Health Index from 155 ± 6 to 174 ± 5 (P=. 0001), the Rosenberg Self- Esteem Scale from 22 ± 1 to 19 ± 1 (P =. 001), the Zung Depression Scale from 0.50 ± 0. 02 to 0. 44 ± 0. 02 (P =.001), and the Diabetes Self- Reliance Test from 60 ± 3 to 74 ± 2 (P=.0001).