Abstract
The aim of the study was to evaluate the effect of a structured group education program administered by a primary care nurse in patients with type 2 diabetes mellitus. The sample included 137 patients with type 2 diabetes mellitus, randomized into two groups: intervention (5-week educational course and reinforcements every 4 months for one year) and control (with no structured diabetes mellitus education) with an evaluation of metabolic control, weight, blood pressure, distress scores, and knowledge on diabetes. There were no differences between the two groups in HbA1c at 4, 8, or 12 months when compared to baseline values. An increase in HbA1c was observed in the control group after adjusting for baseline HbA1c and insulin dose (p = 0.044 between groups). Knowledge scores and diabetes-related distress improved after the intervention. A structured educational program administered to type 2 diabetes mellitus patients seen at a primary care unit improved the knowledge and distress associated with the disease. The results also suggest the prevention of an increase in HbA1c.
Highlights
Diabetes mellitus is associated with chronic microvascular and macrovascular complications 1
A previous meta-analysis of randomized clinical trials 7 has questioned the benefit of currently available educational programs in decreasing HbA1c in type 2 diabetes mellitus: only patients with HbA1c greater than 8% experienced a small improvement (-0.3%)
We have previously demonstrated the efficacy of a group-based education program 8 administered by a nurse certificated diabetes educator (CDE) in a tertiary care university hospital 9
Summary
Diabetes mellitus is associated with chronic microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular complications (ischemic heart disease, cerebrovascular disease, and peripheral vascular disease) 1. Type 2 diabetes mellitus management includes diet, exercise, and medication 3. Diabetes self-management education has been used to encourage lifestyle changes and improve medication compliance 4. The efficacy of diabetes mellitus education has been widely accepted, and the certificated diabetes educator (CDE) is considered an important member of the multidisciplinary team responsible for patient care 5,6. The efficacy of education in terms of HbA1c reduction has not been consistently demonstrated. A previous meta-analysis of randomized clinical trials 7 has questioned the benefit of currently available educational programs in decreasing HbA1c in type 2 diabetes mellitus: only patients with HbA1c greater than 8% experienced a small improvement (-0.3%)
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