de Souza Camila Furtado, Dalzochio Mériane Boeira, Zucatti Alessandra Teixeira Netto, De Nale Rosana, de Almeida Marília Tavares, Gross Jorge Luiz, Leitão Cristiane Bauermann
Primary Care Divison, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Endocrine. 2017 Aug;57(2):280-286. doi: 10.1007/s12020-017-1352-z. Epub 2017 Jun 23.
Community health workers are community members who provide education and care for patients for a broad range of health issues, including diabetes mellitus. However, few community health workers are trained for diabetes education and little is known about the effectiveness of their interventions. The aim of this study is to evaluate the effect of a diabetes education program delivered to community health workers in improving the metabolic control of patients with type 2 diabetes mellitus.
Eight community health workers, providing care for 118 patients, were randomized in two groups to receive a 1-month diabetes education program (intervention, patients n = 62) or an education course in other health issues (control, patients n = 56). Each community health worker was responsible for transmitting the acquired knowledge to patients. Primary outcome was changed in HbA1C 3 months after the intervention.
PARTICIPANTS: Mean age was 61 ± 11 years, 35% were men and 62% were whites. HbA1c levels reduced in both groups (intervention: 9.1 ± 2.2 vs. 7.9 ± 1.9%; control: 9.1 ± 2.1 vs. 8.4 ± 2.5%, p < 0.001), but no statistically significant differences were observed between groups (p between groups = 0.13). Total cholesterol (intervention: 192 ± 43 vs. 182 ± 39 mg/dl; control: 197 ± 44 vs. 191 ± 45 mg/dl, p between groups = 0.035) and triglycerides (intervention: 158 [106-218] vs. 135 [106-215]; control: 128 [100-215] mg/dl vs. 146 [102-203] mg/dl, p between groups = 0.03) reduced overtime only in intervention group.
In this study, a significant decrease in HbA1c was observed during patients' follow-up, but it was similar in intervention and control groups. The diabetes mellitus education course delivered to community health workers was able to improve patients' lipid profile.
社区卫生工作者是为包括糖尿病在内的广泛健康问题的患者提供教育和护理的社区成员。然而，很少有社区卫生工作者接受过糖尿病教育培训，且对其干预效果知之甚少。本研究的目的是评估向社区卫生工作者提供的糖尿病教育计划对改善2型糖尿病患者代谢控制的效果。
八名社区卫生工作者为118名患者提供护理，随机分为两组，一组接受为期1个月的糖尿病教育计划（干预组，患者n = 62），另一组接受其他健康问题的教育课程（对照组，患者n = 56）。每位社区卫生工作者负责将所学知识传授给患者。主要结局是干预后3个月糖化血红蛋白（HbA1C）的变化。
参与者：平均年龄为61±11岁，35%为男性，62%为白人。两组的HbA1c水平均降低（干预组：9.1±2.2 vs. 7.9±1.9%；对照组：9.1±2.1 vs. 8.4±2.5%，p < 0.001），但两组之间未观察到统计学上的显著差异（组间p = 0.13）。总胆固醇（干预组：192±43 vs. 182±39mg/dl；对照组：197±44 vs. 191±45mg/dl，组间p = 0.035）和甘油三酯（干预组：158[106 - 218] vs. 135[106 - 215]；对照组：128[100 - 215]mg/dl vs. 146[102 - 203]mg/dl，组间p = 0.03）仅在干预组随时间降低。
在本研究中，患者随访期间观察到HbA1c显著下降，但干预组和对照组相似。向社区卫生工作者提供的糖尿病教育课程能够改善患者的血脂状况。
