‘Analogy-Based Comprehensive Diabetes Education’ (ABCDE) Improves Glycemic Control of Diabetic Patients in an Underserved Population: Results of a Retrospective Chart Analysis

Abstract

Diabetes is the leading global cause for blindness, kidney failure and amputations. Preventing these complications requires optimal glycemic control, and it is imperative that diabetic patients understand the fundamental concepts of diabetes care. Although patients attend formal diabetes education classes, many do not comprehend basic concepts of diabetes, and are often noncompliant with diet, exercise and medications. A novel approach termed ‘analogy-based comprehensive diabetes education’ (ABCDE) was developed to educate HIV-patients with diabetes about basic concepts of diabetes care. The object of this manuscript is to report the results of a retrospective chart review on the impact of ABCDE on glycemic outcomes in 24 patients who had failed usual care (including formal diabetes education, physician visits, and diabetic medications), and were non-adherent with diet and medications. They received only the ABCDE without any changes in pharmacotherapy. The impact on glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG) was assessed at subsequent visits. HbA1c was found to decline by 22% and 33% after 3 and 6 months, respectively, with corresponding declines in FBG by 53% and 59%, respectively. These results suggest that ABCDE in outpatient diabetes clinics could be effective in behavior modification toward improving glycemic control, and warrants additional investigation.

Chronic disease management program applied to type 2 diabetes patients and prevention of diabetic complications: a retrospective cohort study using nationwide data

“…Under Japan's universal public health insurance system, a five-year follow-up of local disease management programs, including patient education programs with a focus on preventing diabetic complications, showed that these programs were somewhat effective in reducing diabetic complications and the need for emergency care [ 27 ]. In a retrospective chart review conducted in the United States and published in 2022, the effects of comprehensive diabetes education on the reduction of glycated hemoglobin (HbA1c) and fasting blood glucose were reported [ 8 ]. This initiative included explanations of the importance of diet, exercise, medication use, annual eye examinations, hyperglycemia, and HbA1c testing [ 8 ].…”

“…In a retrospective chart review conducted in the United States and published in 2022, the effects of comprehensive diabetes education on the reduction of glycated hemoglobin (HbA1c) and fasting blood glucose were reported [ 8 ]. This initiative included explanations of the importance of diet, exercise, medication use, annual eye examinations, hyperglycemia, and HbA1c testing [ 8 ].…”

“…Consistent glycemic control within the target range and lifestyle modifications, such as maintaining a healthy body weight, eating a healthy diet, being physically active, abstaining from smoking, and consuming alcohol in moderation have been demonstrated to decrease the incidence of diabetic complications [ 7 ]. Additionally, diabetes education by medical personnel can promote medication adherence and healthy lifestyle maintenance, thereby reducing the likelihood of developing complications [ 8 ]. Contrarily, health insurance premiums prioritizes screening, medications, and procedures over education and counseling due to insufficient evidence regarding the latter’s efficacy.…”