[Withdrawal of a specialised diabetes education program in primary care: long term impact on the metabolic control outcomes].

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.