Center of Experimental and Applied Endocrinology, La Plata National Scientific and Technical Research Council-La Plata National University, PAHO/WHO Collaborating Centre for Diabetes, La Plata, Argentina.
Diabetes Metab. 2012 Apr;38(2):128-34. doi: 10.1016/j.diabet.2011.09.002. Epub 2011 Oct 22.
To evaluate the impact of diabetes education provided to patients with type 2 diabetes mellitus (T2DM) in non-controlled studies ("real-world conditions") on quality of care, resource consumption and conditions of employment.
This cross-sectional study and longitudinal follow-up describe the data (demographic and socioeconomic profiles, clinical characteristics, treatment of hyperglycaemia and associated cardiovascular risk factors, resource consumption) collected during the second phase (2006) of the International Diabetes Management Practices Study (IDMPS). Patients received diabetes education directly from the practice nurse, dietitian or educator, or were referred to ad hoc group-education programmes; all programmes emphasized healthy lifestyle changes, self-care and active participation in disease control and treatment. Educated vs non-educated T2DM patients (n=5692 in each group), paired by age, gender and diabetes duration, were randomly recruited for the IDMPS by participating primary-care physicians from 27 countries in Eastern Europe, Asia, Latin America and Africa. Outcome measures included clinical (body weight, height, waist circumference, blood pressure, foot evaluation), metabolic (HbA(1c) levels, blood lipid profile) and biochemical control measures. Treatment goals were defined according to American Diabetes Association guidelines.
T2DM patients' education significantly improved the percentage of patients achieving target values set by international guidelines. Educated patients increased their insulin use and self-care performance, had a lower rate of chronic complications and a modest increase in cost of care, and probably higher salaries and slightly better productivity.
Diabetes education is an efficient tool for improving care outcomes without having a major impact on healthcare costs.
评估在非对照研究（“真实世界条件”）中为 2 型糖尿病（T2DM）患者提供的糖尿病教育对医疗质量、资源消耗和就业状况的影响。
本横断面研究和纵向随访描述了在国际糖尿病管理实践研究（IDMPS）第二阶段（2006 年）收集的数据（人口统计学和社会经济特征、临床特征、高血糖治疗和相关心血管危险因素、资源消耗）。患者接受了来自执业护士、营养师或教育者的直接糖尿病教育，或被转介到专门的小组教育计划；所有计划都强调健康的生活方式改变、自我护理和积极参与疾病控制和治疗。接受教育的 T2DM 患者（每组 5692 例）与未接受教育的患者（每组 5692 例）按年龄、性别和糖尿病病程进行配对，由来自东欧、亚洲、拉丁美洲和非洲的 27 个国家的参与初级保健医生通过 IDMPS 随机招募。结局指标包括临床（体重、身高、腰围、血压、足部评估）、代谢（HbA1c 水平、血脂谱）和生化控制措施。治疗目标根据美国糖尿病协会指南定义。
T2DM 患者的教育显著提高了达到国际指南设定的目标值的患者比例。接受教育的患者增加了胰岛素使用和自我护理表现，慢性并发症发生率较低，医疗费用略有增加，可能工资更高，生产力略有提高。
糖尿病教育是改善护理结果的有效工具，对医疗保健成本没有重大影响。
