Effectiveness of a Structured Educational Program for Type 2 Diabetic Patients in Outpatient Care

Abstract

The objective of this study was to evaluate the effectiveness of structured education of patients with type 2 diabetes in the disease management within the scopeof endocrinological outpatient care. The study was performed among the adult cohort of patients with type 2 diabetes, that were monitored in outpatient servicein Astana.According to the study results 70% of patients with type 2 diabetes, who were observed in outpatient setting, were in a state of poor compensation. Intermediate HbA1clevel was 9,25±0,15%, average BMI was 29,3±0,5 kg/m2, average systolic blood pressure of 154±3,1mm.rt.art., averagediastolic blood pressure 88±1,4 mm.rt.art., total cholesterol 6,94±0,8 mmol/l, triglycerides 1,78±0,1 mmol/l. The study showed significant improvement in compensation of diabetes in patients that attended educational program in comparison with the control group: HbA1c decreased from 9,33±0,18% to 8,21±0,12%. One‐time training course does not lead to long‐term metabolic compensation: after 12 months there was an increase NbA1s with 8,21±0,12% to 8,5±0,12%. In the absence of post‐training self‐monitoring of the blood glucose level, the effectiveness of trainingdecreased: the indicator HbA1cin trained patients but without further self‐monitoring rose again up to 9,3±0,31%, and in patients without any training ‐ 9,33±0,18 p>0.05. According to the test results using a SpielbergerState‐Trait Anxiety questionnaire there was a high level of personal anxiety in 73.3% of patients, which indicatedthat patients were in a state of constant stress. After undergoing the educational program a positive correction of psychological condition of the patients was observed, through decreased level of anxiety: high level of situational anxiety during the training decreased from 24.5% to 8.9%, p<0.05.