La supresión de la educación especializada empeora el control metabólico en diabetes tipo 2

Abstract

Aims To evaluate the possible relationships between a health policy decision, in relation to the diabetes education strategies and the metabolic control outcomes. Design Longitudinal prospective cohort study. Participants A random cohort sample of 276 type II diabetes mellitus subjects. Location All primary care centres in three regions of Catalonia. Principal measurements Patients were classified as specialised (n=59) or non-specialised (n=217) groups, as regards whether having received previous diabetes education before the start of the study. HbA1c values were evaluated in all subjects at baseline and after 5 years after receiving only conventional education. Results Baseline evaluation showed a better metabolic control in the specialised group ( P=0.009). The final evaluation showed no significant differences in outcomes between the two groups ( P=0.679). When baseline and outcomes values were compared, significant differences were observed in all subjects ( P=0.001), the specialised group showed significantly poorer metabolic control ( P<0.001), but in the group with previous conventional education no significant differences were observed ( P=0.058). Conclusions Our results suggest that the withdrawal of higher levels of diabetes education may play a major role in poor metabolic control, and that conventional diabetes education does not improve outcomes. Health policy in Primary Care should consider improving the level of diabetes education.