***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare glycemic control and secondary outcomes of a 4-month telephonic couples behavioral intervention to individual intervention , and to education , for adults with type 2 diabetes . RESEARCH DESIGN AND METHODS A r and omized trial with the following three arms :  couples calls ( CC ) ( n = 104 ) ; individual calls ( IC ) ( n = 94 ) ; and diabetes education ( DE ) ( n = 82 ) . All arms had self-management education ( two calls ) . CC and IC had 10 additional behavior change calls . CC addressed collaboration and relationships/communication . Participants consisted of 280 couples , among whom one partner had type 2 diabetes and an A1C level ≥7.5 % . Blinded assessment s occurred at 4 , 8 , and 12 months . The primary outcome was change in A1C ; and secondary outcomes were BMI , waist circumference , blood pressure , depressive symptoms , diabetes self-efficacy , and diabetes distress . RESULTS Patients had a mean age of 56.8 years ; 61.6 % were male , and 30.4 % were minorities . The baseline mean A1C level was 9.1 % . Intention-to-treat analyses found significant A1C reductions for all ( 12 months : CC −0.47 % , IC −0.52 % , DE −0.57 % ) , with no differences between arms . Preplanned within-arm analyses were stratified by baseline A1C tertiles : lowest tertile ( 7.5–8.2 % ) , no change from baseline ; middle tertile ( 8.3–9.2 % ) , only CC led to significantly lower A1C level ; and highest tertile ( ≥9.3 % ) , significant improvement for all interventions . For BMI , CC showed significant improvement , and CC and DE led to decreased waist circumference . The IC group showed greater blood pressure improvement . Results for secondary psychosocial outcomes favored the CC group . CONCLUSIONS In adults with poorly controlled type 2 diabetes , a collaborative couples intervention result ed in significant , lasting improvement in A1C levels , obesity measures , and some psychosocial outcomes . For those with exceedingly high A1C levels , education alone was beneficial , but additional intervention is needed to achieve glycemic targets Background Many community-based self-management programs have been developed for older adults with type-2 diabetes mellitus ( T2DM ) , bolstered by evidence from r and omized controlled trials ( RCTs ) that T2DM can be prevented and managed through lifestyle modifications . However , the evidence for their effectiveness is contradictory and weakened by reliance on single-group design s and /or small sample s. Additionally , older adults with multiple chronic conditions ( MCC ) are often excluded because of recruiting and retention challenges . This paper presents a protocol for a two-armed , multisite , pragmatic , mixed- methods RCT examining the effectiveness and implementation of the Aging , Community and Health Research Unit-Community Partnership Program ( ACHRU-CPP ) , a new 6-month interprofessional , nurse-led program to promote self-management in older adults ( aged 65 years or older ) with T2DM and MCC and support their caregivers ( including family and friends ) . Methods / design The study will enroll 160 participants in two Canadian provinces , Ontario and Alberta . Participants will be r and omly assigned to the control ( usual care ) or program study arm . The program will be delivered by registered nurses ( RNs ) and registered dietitians ( RDs ) from participating diabetes education centers ( Ontario ) or primary care networks ( Alberta ) and program coordinators from partnering community-based organizations . The 6-month program includes three in-home visits , monthly group sessions , monthly team meetings for providers , and nurse-led care coordination . The primary outcome is the change in physical functioning as measured by the Physical Component Summary ( PCS-12 ) score from the short form-12v2 health survey ( SF-12 ) . Secondary client outcomes include changes in mental functioning , depressive symptoms , anxiety , and self-efficacy . Caregiver outcomes include health-related quality of life and depressive symptoms . The study includes a comparison of health care service costs for the intervention and control groups , and a subgroup analysis to determine which clients benefit the most from the program . Descriptive and qualitative data will be collected to examine implementation of the program and effects on interprofessional/team collaboration . Discussion This study will provide evidence of the effectiveness of a community-based self-management program for a complex target population . By study ing both implementation and effectiveness , we hope to improve the uptake of the program within the existing community-based structures , and reduce the research -to- practice gap . Trial registration Clinical Trials.gov , Identifier : NCT02158741 . Registered on 3 June 2014 Background : Non-adherence to oral antidiabetics drugs ( OADs ) has been a common problem and may contribute to poor glycemic control . Aim : To describe an experimental study protocol that aims at implementing and evaluating the effect of the “ action planning and coping planning ” interventions on medication adherence to OADs  in patients with type 2 diabetes mellitus ( T2DM ) in follow-up at primary care services . Design : A r and omized controlled trial . Methods : Two groups ( intervention and control ) will be followed over a period of 105 days . The intervention group will receive a combination of the “ action planning ” and “ coping planning ” intervention strategies . There will be in-person meetings and phone calls to reinforce the intervention . The control group will receive the usual care from the health unit . Conclusions : It is hoped that this study will help health professionals to improve their approach with patients who have T2DM in relation to medication adherence AIMS Examine barriers for taking  glucose-lowering oral medications  , associated baseline characteristics , strategies used , and the adherence impact in the Treatment Options for Type 2 Diabetes in Adolescents and Youth ( TODAY ) study . METHODS We studied youth prescribed oral diabetes medications over two years ( N = 611 , 583 , and 525 at 6 , 12 , and 24 months ) . Clinicians documented barriers ( e.g. forgetting , routines , other concerns ) in the sub sample that reported missed doses ( N = 423 [ 69.2 % ] , 422 [ 72.4 % ] , and 414 [ 78.9 % ] at 6 , 12 , and 24 months , respectively ) . Adherence strategies were also assessed ( e.g. family , schedule , reminder device ) using st and ard questions . Logistic regression was used to analyze associations with medication adherence . RESULTS Those missing doses were not different from the total sample ( 61.5 % female , 13.9 ± 2.0 years , > 80 % racial/ethnic minorities ) . No baseline demographic or clinical predictors of barriers to medication adherence were identified . Among those for whom barriers were assessed , " forgetting " with no reason named ( 39.3 % ) and disruptions to mealtime , sleep , and schedule ( 21.9 % ) accounted for the largest proportion of responses . Family support was the primary adherence strategy identified by most youth ( ≥50 % ) , followed by pairing the medication regimen with daily routines ( > 40 % ) ; the latter strategy was associated with significantly higher adherence rates ( p = 0.009 ) . CONCLUSIONS Family supported medication adherence was common in this mid-adolescent cohort , but self-management strategies were also in evidence . Findings are similar to those reported among youth with other serious chronic diseases . Prospect i ve studies of multi-component family support and self-management interventions for improving medication adherence are warranted . TRIAL REGISTRATION Clinical Trials.gov NCT00081328 AIMS We evaluated a theoretically-derived family-oriented intervention aim ed to improve self-efficacy , self-management , glycemic control and quality of life in individuals living with Type 2 diabetes in Thail and . METHODS In a single-blinded r and omized controlled trial , 140 volunteer individuals with Type 2 diabetes , recruited from a diabetes clinic in rural Thail and , were r and omly allocated to intervention and control arms . Those in the intervention arm received routine care plus a family-oriented program that included education classes , group discussion s , a home visit , and a telephone follow-up while the control arm only received routine care . Improvement in outcomes over time ( baseline , Week 3 , and Week 13 following intervention ) was evaluated using Generalized Estimating Equations multivariable analyses . RESULTS Except for age , no between-group significant differences were observed in all other baseline characteristics . Diabetes self-efficacy , self-management , and quality of life improved in the intervention arm but no improvement was observed in the controls . In the risk-adjusted multivariable models , compared to the controls , the intervention arm had significantly better self-efficacy , self-management , outcome expectations , and diabetes knowledge ( p<0.001 , in each ) . Participation in the intervention increased the diabetes self-management score by 14.3 points ( β=14.3 , ( 95 % CI 10.7 - 17.9 ) , p<0.001 ) . Self-management was better in leaner patients and in females . No between-group differences were seen in quality of life or glycemic control , however , in the risk-adjusted multivariable models , higher self-management scores were associated with significantly decreased HbA1c levels ( p<0.001 ) and improved patient quality of life ( p<0.05 ) ( irrespective of group membership ) . CONCLUSIONS Our family-oriented program improved patients ' self-efficacy and self-management , which in turn could decrease HbA1c levels Objective Spousal clustering of diabetes merits attention . Whether old-age vulnerability or a shared family environment determines the concordance of diabetes is also uncertain . This study investigated the spousal concordance of diabetes and compared the risk of diabetes concordance between couples and noncouples by using nationally representative data . Methods A total of 22,572 individuals identified from the 2002–2013 National Health Insurance Research Data base of Taiwan constituted 5,643 couples and 5,643 noncouples through 1:1 dual propensity score matching ( PSM ) . Factors associated with concordance in both spouses with diabetes were analyzed at the individual level . The risk of diabetes concordance between couples and noncouples was compared at the couple level . Logistic regression was the main statistical method . Statistical data were analyzed using SAS 9.4 . C&RT and Apriori of data mining conducted in IBM SPSS Modeler 13 served as a supplement to statistics . Results High odds of the spousal concordance of diabetes were associated with old age , middle levels of urbanization , and high comorbidities ( all P < 0.05 ) . The dual PSM analysis revealed that the risk of diabetes concordance was significantly higher in couples ( 5.19 % ) than in noncouples ( 0.09 % ; OR = 61.743 , P < 0.0001 ) . Conclusions A high concordance rate of diabetes in couples may indicate the influences of assortative mating and shared environment . Diabetes in a spouse implicates its risk in the partner . Family-based diabetes care that emphasizes the screening of couples at risk of diabetes by using the identified risk factors is suggested in prospect i ve clinical practice interventions Background This paper presents the pilot study and protocol for a r and omised controlled trial to test the effectiveness of a psychological , family-based intervention to improve outcomes in those with poorly controlled type 2 diabetes . The intervention has been design ed to change the illness perceptions of patients with poorly controlled type 2 diabetes , and their family members . It is a complex psychological intervention , developed from the Self-Regulatory Model of Illness Behaviour . The important influence the family context can have in psychological interventions and diabetes management is also recognised , by the inclusion of patients ' family members . Methods / design We aim to recruit 122 patients with persistently poorly controlled diabetes . Patients are deemed to have persistent poor control when at least two out of their last three HbA1c readings are 8.0 % or over . Patients nominate a family member to participate with them , and this patient/family member dyad is r and omly allocated to either the intervention or control group . Participants in the control group receive their usual care . Participants in the intervention group participate , with their family members , in three intervention sessions . Sessions one and two are delivered in the participant 's home by a health psychologist . Session one takes place approximately one week after session two , with the third session , a follow-up telephone call , one week later . The intervention is based upon clarifying the illness perceptions of both the patient and the family member , examining how they influence self-management behaviours , improving the degree of similarity of patient and family member perceptions in a positive direction and developing personalized action plans to improve diabetes management . Discussion This study is the first of its kind to incorporate the evidence from illness perceptions research into developing and applying an intervention for people with poorly controlled diabetes and their families . This study also acknowledges the important role of family members in effective diabetes care . Trial registration IS RCT Objective To evaluate 8-year weight losses achieved with intensive lifestyle intervention ( ILI ) in the Look AHEAD ( Action for Health in Diabetes ) study . Design and Methods Look AHEAD assessed the effects of intentional weight loss on cardiovascular morbidity and mortality in 5,145 overweight/obese adults with type 2 diabetes , r and omly assigned to ILI or usual care ( i.e. , 
    Output:
    
Partner and family have similar diet , lifestyle , and micro- and macro-environments which could explain the similar increased risk of diabetes and non-communicable diseases .
Partner support has major role in prevention and control of diabetes distress , associated depression , and medication non-compliance which have an adverse impact in glycaemic outcomes .
Conclusion : The support of family and spouse/partner is beneficial to improve adherence to the lifestyle interventions and pharmacotherapy required to achieve optimum glycaemic control and avoid associated complications