Effects of a structured education program on glycemic control in type 1 diabetes

Abstract

Objective: Diabetes mellitus is associated with significant morbidity and mortality, and education is known to play a key role in managing this disease. This study addresses the effects of a structured education program (SEP) on self-care in subjects with type 1 diabetes mellitus (T1DM). The aim was to evaluate the effect of a SEP on glycemic control, knowledge, and skills associated with diabetes care in subjects with T1DM. Subjects and methods: A total of 47 adults with T1DM were followed up for 20 months (32 participated in the SEP and 15 served as a control group). The SEP consisted of workshops, individualized care, 24-hour distant support, and a questionnaire assessing knowledge of diabetes care. Glycosylated hemoglobin (HbA1c) levels were measured before and after the SEP implementation. Results: Compared with pre-SEP levels, the mean HbA1c levels decreased by approximately 20% (21 mmol/mol) at 1 year, with a further 11% reduction (10 mmol/mol) observed 8 months later (p < 0.001). Knowledge about diabetes care increased by 37% between the pre-SEP and post-SEP questionnaires (p < 0.005). Conclusion: Relevant improvements occurred after SEP activities. The sustained decrease in HbA1c levels and the overall increase in knowledge and confidence regarding diabetes care reinforce the importance, necessity, and positive outcomes of a SEP intervention in T1DM. Arch Endocrinol Metab. 2017;61(6):534-41

Comparison of the effect of a compact vs a conventional, long-term education program on metabolic control in children and adolescents with type 1 diabetes: A pilot, randomized clinical trial

“…There is also a lack of good-quality studies involving children and adolescents with T1DM. In a meta-analysis 11 Pacheco et al, 19 using an adaptation of the Dose Adjustment for Normal Eating model, observed an improvement of 31% in HbA1c levels 18 months after an educational intervention. However, the study was not randomized, the control group had patients who had refused participation in the study, and the initial HbA1c was significantly higher, amplifying the effect of the intervention.…”

Repercussões da prática educativa no autocuidado e manejo do Diabetes Mellitus tipo 1 na infância

“…A partir da compreensão de regras sobre objetos internos e suas relações, podem ser instruídas sobre o que é sua doença e aprender a desenvolver as atividades específicas e invasivas, como verificação da glicemia capilar e aplicação de insulina. 20 Assumir responsabilidade própria nos papéis de autocuidado inerentes ao manejo da doença requer grau de maturidade e desenvolvimento cognitivo. 21 Para distinguir entre o real e o imaginário, a criança nessa fase busca recursos na sua inteligência emocional, procurando motivar a si mesma, mesmo diante das frustrações, tenta controlar impulsos pela canalização das emoções para outras situações que lhe deem prazer.…”

Insulin therapy is a personalized approach to glycemic management in diabetes

“…Благодаря многочисленным исследованиям достоверно установлено, что программы терапевтического ведения, включающие структурированное обучение регулярному СКГ (самостоятельная адаптация дозы инсулина, распорядок дня и режим питания, основанный на системе подсчета хлебных единиц -ХЕ, и др. ), приводят к лучшему снижению HbA 1c у пациентов с СД по сравнению с программами без самоконтроля или в которых СКГ носит общий подход без индивидуального обучения пациентов СКГ [28][29][30][31][32].…”