A Model Educational Program for People With Type 2 Diabetes

Abstract

OBJECTIVE -To implement an educational program in 10 Latin American countries and to evaluate its effect on the clinical, biochemical, and therapeutic aspects as well as the economic cost of diabetes.RESEARCH DESIGN AND METHODS -Educators from each participating country were previously trained to implement the educational model. The patient population included 446 individuals with type 2 diabetes; all patients were Ͻ65 years of age, did not require insulin for metabolic control, did not have severe complications of diabetes or life-limiting illnesses, and had not previously participated in diabetes education courses. Clinical and therapeutic data and the cost of their pharmacological treatment were collected 6 months before participation in the educational program (Ϫ6 months), on entry into the program (time 0), and at 4, 8, and 12 months after initiation of the program.RESULTS -All parameters measured had improved significantly (P Ͻ 0.001) by 1 year: fasting blood glucose (mean Ϯ SD) 10.6 Ϯ 3.5 vs. 8.7 Ϯ 3.0 mmol/l; HbA 1c 9.0 Ϯ 2.0 vs. 7.8 Ϯ 1.6%; body weight 84.6 Ϯ 14.7 vs. 81.2 Ϯ 15.2 kg; systolic blood pressure 149.6 Ϯ 33.6 vs. 142.9 Ϯ 18.8 mmHg; total cholesterol 6.1 Ϯ 1.1 vs. 5.4 Ϯ 1.0 mmol/l; and triglycerides 2.7 Ϯ 1.8 vs. 2.1 Ϯ 1.2 mmol/l. At 12 months, the decrease in pharmacotherapy required for control of diabetes, hypertension, and hyperlipidemia represented a 62% decrease in the annual cost of treatment ($107,939.99 vs. $41,106.30 [U.S.]). After deducting the additional cost of glucosuria monitoring ($30,604), there was still a 34% annual savings. CONCLUSIONS -The beneficial results of this educational model, implemented in 10Latin American countries, reinforce the value of patient education as an essential part of diabetes care. They also suggest that an educational approach promoting healthy lifestyle habits and patient empowerment is an effective strategy with the potential to decrease the development of complications related to diabetes as well as the socioeconomic costs of the disease.

Meta-analysis does not allow appraisal of complex interventions in diabetes and hypertension self-management: a methodological review

“…Following the selection criteria of the reviews, 16 publications [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] referring to our three reference programmes should have been identified. In practice, a total of 11 were identified [5,28,30,32,34,38,39,[43][44][45][46], and seven [28,32,34,35,38,39,46] were included in at least one of the reviews.…”

Incidence and prevalence of diabetes mellitus in the Americas

“…Diabetes prevention and control programs are urgently needed and are potentially cost-effective strategies that can reduce the huge burden of diabetes (63). Disease control programs should address the comparatively higher prevalence of diabetes reported among women, the less educated, and low-income populations in the Americas.…”

Development and Implementation of Advanced Training Course for Diabetes Educators in Argentina

“…The implementation of a structured group education program for people with type 2 diabetes was both cost-effective and cost-beneficial, 25 resembling data reported in developed countries. 4,5,[7][8][9][10] Therefore, diabetes education, even in underserved populations, can significantly improve diabetes self-care with a consequent benefit in terms of metabolic outcomes, costs, and quality of life.…”