The Impact of Diabetes Education on Improving Patient Outcomes

Abstract

Background: Diabetes education provided by certified diabetes educators (CDEs) can help improve the lives of patients with diabetes mellitus (DM). With morbidity, mortality, and medical costs of increasing concern, diabetes educators must provide patients and primary caregivers with the tools to improve their DM and the motivation and understanding to help them meet their goals. Objective: The goal of this article was to determine the effectiveness of education provided by CDEs in an American Diabetes Association-recognized outpatient program for adults. Methods: Review of the literature from 2003 to 2006 was undertaken using the search terms diabetes education, efficacy of lifestyle education, AIC reduction, and certified diabetes educators. Landmark studies such as the Diabetes Control and Complications Trial, the United Kingdom Prospective Diabetes Study, and the Diabetes Prevention Program were also cited. The staff at Saint Joseph's Hospital, Center for Diabetes Care, developed a questionnaire to ascertain how patients were managing key indicators related to DM. Data were gathered on patients who had both an initial visit (IV) during 2003 and 2004 and a follow-up visit (FUV) that typically took place 4.5 months later. During their IV, patients were assessed, provided with basic information, and set goals. They then participated in 2 subsequent classes within the next few months on DM self-management and returned for the FUV The questionnaire was completed at both the IV and FUV The answers were blinded. Data were examined to determine if diabetes education provided by CDEs changed patient behaviors and decreased glycosylated hemoglobin (A1C) values. Results: A total of 501 patients had an IV and an FUV Between visits, mean AlC level decreased significantly from 7.9% to 6.7%; mean weight decreased significantly from 198.6 to 196.0 lb; systolic blood pressure decreased from 132.8 to 131.5 mm Hg and diastolic blood pressure decreased from 79.4 to 77.1 mm Hg; medication adherence increased from 5% to 21% for 4 classes of medication; exercise increased from 58% (284) to 80% (403) of patients; and self-monitoring of blood glucose levels increased from 53% (260) to 98% (476) of patients. More than half of the 89% (446) of patients who set goals at the W met their goals. Conclusion: The diabetes education provided by CDEs helped patients adopt the healthier lifestyle behaviors needed to control their DM and to reduce their AlC levels.