A closer look at teaching and contingency contracting with type II diabetes

The purpose of this study was to determine which of two interventions was more effective in assisting Type II non-insulin dependent diabetics to achieve control. Subjects were considered to have their disease under control if their blood glucose was within normal limits and they either maintained or lost a prescribed amount of weight. In a 2 × 2 × 8 repeated measures analysis of variance design, 60 overweight subjects (30 treated with diet alone and 30 treated with diet and oral hypoglycemics) were randomly assigned to one of two interventions, teaching alone or teaching with contingency contracting. The interventions were carried out weekly for 8 weeks in the home setting. Findings revealed a significant weight loss and an increase in knowledge across subjects with no differences between groups. No significant differences were noted for fasting blood glucose or glycosylated hemoglobin measurements either across or between groups. These results support the need to individualize interventions directed toward behavior change and provide insight into contingency contracting as one approach.