Diabetes Self-Management Education

Clement, Stephen

doi:10.2337/diacare.18.8.1204

Cited by 331 publications

(215 citation statements)

References 28 publications

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“…Usually, patient education is offered as an adjunct to clinical care, within routine one-to-one visits or as self-contained structured courses for individuals or groups [4,5,13,14]. This requires allocation of additional time and resources that are scarce in most clinics.…”

Section: Introductionmentioning

confidence: 99%

A 3-year prospective randomized controlled clinical trial of group care in type 1 diabetes

Trento

Passera

Borgo

et al. 2005

Nutrition, Metabolism and Cardiovascular Diseases

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Summary Background and aims: We showed that continuing education can be embedded into routine diabetes care by seeing patients in small groups rather than individually. Group care was cost-effective in improving quality of life, knowledge of diabetes, health behaviours and clinical outcomes in people with type 2 diabetes. The aim of this study was to verify if group care can also be applied to type 1 diabetes. Methods and results: Randomized, controlled clinical trial comparing 31 patients managed by group care with 31 managed by traditional one-to-one care. A syllabus was built and later remodulated with the patients in a series of focus-group meetings. The primary end-point was changes in quality of life. Secondary endpoints were: knowledge of diabetes, health behaviours, HbA1c and circulating lipids. Differential costs to the Italian National Health System and to the patients were also calculated.After 3 years, quality of life improved among patients on group care, along with knowledge and health behaviours (p ! 0.001, all). Knowledge added its effects to those of group care by independently influencing behaviours (p Z 0.004) while quality of life changed independently of either (p ! 0.001). Among controls, quality of life worsened (p ! 0.001) whereas knowledge and behaviours remained unchanged. HDL cholesterol increased among patients on group care (p Z 0.027) and total cholesterol decreased in the controls (p ! 0.05). HbA1c

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Section: Introductionmentioning

confidence: 99%

A 3-year prospective randomized controlled clinical trial of group care in type 1 diabetes

Trento

Passera

Borgo

et al. 2005

Nutrition, Metabolism and Cardiovascular Diseases

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“…Meta-analyses and reviews of the diabetes literature have shown that diabetes self-management education is effective in improving knowledge, skill, self-care behaviors, psychosocial outcomes, and metabolic control. [132][133][134][135][136][137][138][139] A recent epidemiologic study from Italy found that limited access to care and lack of an educational intervention led to an increased risk of developing the complications of diabetes, while self-management of insulin had a protective effect. 140 Other studies have shown the benefits of diabetes foot care education in preventing amputations, 87,141 and the efficacy of ongoing nutritional care.…”

Section: Self-management Educationmentioning

confidence: 99%

“…142 Self-management education is most effective when presented in collaboration with a provider who can reinforce this information. 134,143,144 Therefore, an important part of the primary care provider's role is to review and update the information the patient needs to manage the disease, ascertain the extent to which the patient is managing the disease appropriately, reinforce self-management behaviors, and refer to diabetes education programs or nutritionists. Table 3 lists important self-management topics and questions about issues that will help elicit the patient's understanding of diabetes care.…”

Section: Self-management Educationmentioning

confidence: 99%

Screening, prevention, counseling, and treatment for the complications of type II diabetes mellitus

et al. 1997

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PURPOSE:To summarize current knowledge of interventions that should improve the care of patients with type II diabetes mellitus. Interventions lie within the realms of prevention, screening, and treatment, all of which are focused on office practice. METHODS:Review of the literature by a multidisciplinary team involved in the care of patients with diabetes, followed by synthesis of the literature into a clinical care guideline. Literature was identified through consultation with experts and a focused MEDLINE search. MAIN RESULTS:An algorithm-based guideline for screening and treatment of the complications of diabetes was developed. The emphasis is on prevention of atherosclerotic disease, and prevention, screening, and early treatment of microvascular disease. Implementation of these practices has the potential to significantly improve quality of life and increase life expectancy in patients with type II diabetes mellitus. ype II diabetes is a common condition, affecting 2% to 3% of the adult population, and up to 20% to 25% of the elderly population. 1 Type II diabetes typically occurs in patients who are over 30 years old and weigh more than 120% of ideal body weight, and accounts for 90% of all cases of diabetes mellitus diagnosed in the United States. 1 Minorities have a prevalence of type II diabetes mellitus that is 2 to 6 times greater than that of white persons. The morbidity and mortality are higher for minorities than for white persons, and the rate is increasing. 2 The reasons for this disparity remain unclear, but could include differences in disease severity, comorbidities, or access to care.Diabetes has significant associated morbidity. Prevention and treatment of the complications of diabetes mellitus have the potential to improve quality of life and increase life expectancy. 3 The rate of cardiovascular disease is markedly elevated among patients with type II diabetes, leading to an increased mortality rate compared with the general population. 4,5 In addition, microvascular complications, which include retinopathy, nephropathy, and neuropathy, can progress to end-stage outcomes such as blindness, end-stage renal disease (ESRD), and amputation. Screening and early treatment for diabetic complications have been shown to be effective in reducing the incidence of end-stage disease 6,7 ; despite this evidence, implementation rates of recommended interventions are low. 8 This frequently leads to ineffective or delayed treatment of complications. 9-11 Because optimal diabetes care is a complex process, we developed a clinical care guideline to help busy clinicians incorporate prevention, screening, and treatment recommendations into practice. METHODSA multidisciplinary team was assembled to develop an evidence-based guideline for the prevention and treatment of complications of type II diabetes. The multidisciplinary team included members from endocrinology, family practice, general internal medicine, obstetrics-gyncecology, nursing, and postgraduate medicine departments. Team members have an interest ...

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“…There is a significant deficit in knowledge and skill in 50% to 80% of individuals with DM (8) . Glucose control assessed through glycated hemoglobin test (HbA1c) is reached in less than half the patients with type 2 DM (9) .…”

Section: Introductionmentioning

confidence: 99%

“…A proper metabolic condition is a result of several factors such as patients awareness on pathophysiological aspects and those concerned with disease treatment, nutritional reeducation, increase in physical activity, regular foot assessment, selfmonitoring of capillary glucose, signs and symptoms of hypoglycemia, and prevention of chronic diseases, disease management in special situations and family support (1,5,(7)(8) .…”

Section: Introductionmentioning

confidence: 99%

Conhecimento sobre terapêutica medicamentosa em diabetes: um desafio na atenção à saúde

et al. 2009

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Patients' knowledge regarding medication therapy to treat diabetes: a challenge for health care services* Conocimiento sobre la terapéutica medicamentosa en diabetes: un desafío en la atención a la salud Heloisa Turcatto Gimenes Faria 1 , Maria Lúcia Zanetti 2 , Manoel Antônio dos Santos 3 , Carla Regina de Souza Teixeira 4 ABSTRACT Objective: To assess and describe patients' knowledge regarding medication therapy to treat diabetes mellitus. Methods: This descriptive cross-sectional study was conducted in 2007 at a university center in the interior of São Paulo State, Brazil. Forty-six patients with diabetes were interviewed using a structured questionnaire to gather sociodemographic, clinical, and medication information. Data analysis consisted of univariate statistics and measures of central tendency. Results: The majority of participants (89.1%) used oral hypoglycemic agents, 41.3% used insulin injections, and 30.4% used a combination therapy oral hypoglycemic agents and insulin injections. A large number of participants (56.5%) had knowledge deficit regarding their medication regimen. Conclusion: The findings suggest the need to develop a more effective patient orientation process in the health care services. It is not enough to offer the medication; one must also comprehensively assess patients' knowledge and use of the medication. Keywords: Nursing; Diabetes mellitus; Evaluation; Patient education as topic RESUMO Objetivo: Avaliar o conhecimento dos pacientes acerca da terapia medicamentosa em uso para o controle do diabetes mellitus. Métodos: Estudo descritivo transversal realizado em um centro universitário do interior paulista, em 2007. Foram entrevistados 46 pacientes com diabetes, mediante questionário que investigou variáveis sociodemográficas, clínicas e referentes à terapia medicamentosa. Foi realizada análise univariada dos dados e cálculo de medidas de tendência central. Resultados: Dos participantes, 89,1% utilizavam antidiabéticos orais, 41,3% insulina e 30,4% terapia combinada com antidiabéticos orais e insulina. Dos 46 investigados, 56,5% apresentaram déficit no conhecimento acerca da terapia medicamentosa para o controle do diabetes mellitus. Conclusão: A maioria dos pacientes apresentou déficit de conhecimento em relação ao medicamento em uso. Os resultados apontam a necessidade de construção de um processo de reorientação da atenção ao paciente nos serviços de saúde, pois não basta oferecer os medicamentos, mas é preciso avaliar a forma como vêm sendo utilizados. Descritores: Enfermagem; Diabetes mellitus; Avaliação; Educação do paciente como assunto RESUMEN Objetivo: Evaluar el conocimiento de los pacientes respecto a la terapia medicamentosa usada para el control de la diabetes mellitus. Métodos: Se trata de un estudio descriptivo transversal realizado en un centro universitario del interior de São Paulo, en el 2007. Fueron entrevistados 46 pacientes con diabetes, mediante un cuestionario que permitió investigar variables sociodemográficas, clínicas y referentes a la terapia medicamentos...

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Diabetes Self-Management Education

Cited by 331 publications

References 28 publications

A 3-year prospective randomized controlled clinical trial of group care in type 1 diabetes

A 3-year prospective randomized controlled clinical trial of group care in type 1 diabetes

Screening, prevention, counseling, and treatment for the complications of type II diabetes mellitus

Conhecimento sobre terapêutica medicamentosa em diabetes: um desafio na atenção à saúde

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