The Diabetes Education Study: A Controlled Trial of the Effects of Diabetes Patient Education

Abstract

The Diabetes Education Study (DIABEDS) was a randomized, controlled trial of the effects of patient and physician education. This article describes a systematic education program for diabetes patients and its effects on patient knowledge, skills, self-care behaviors, and relevant physiologic outcomes. The original sample consisted of 532 diabetes patients from the general medicine clinic at an urban medical center. Patients were predominantly elderly, black women with non-insulin-dependent diabetes mellitus of long duration. Patients randomly assigned to experimental groups (N = 263) were offered up to seven modules of patient education. Each content area module contained didactic instruction (lecture, discussion, audio-visual presentation), skill exercises (demonstration, practice, feedback), and behavioral modification techniques (goal setting, contracting, regular follow-up). Two hundred seventy-five patients remained in the study throughout baseline, intervention, and postintervention periods (August 1978 to July 1982). Despite the requirement that patients demonstrate mastery of educational objectives for each module, postintervention assessment 11-14 mo after instruction showed only rare differences between experimental and control patients in diabetes knowledge. However, statistically significant group differences in self-care skills and compliance behaviors were relatively more numerous. Experimental group patients experienced significantly greater reductions in fasting blood glucose (-27.5 mg/dl versus -2.8 mg/dl, P less than 0.05) and glycosylated hemoglobin (-0.43% versus + 0.35%, P less than 0.05) as compared with control subjects. Patient education also had similar effects on body weight, blood pressure, and serum creatinine. Continued follow-up is planned for DIABEDS patients to determine the longevity of effects and subsequent impact on emergency room visits and hospitalization.

Lifestyle intervention by group care prevents deterioration of Type II diabetes: a 4-year randomized controlled clinical trial

“…Health education should not confine itself to providing information on disease and treatment options, because most notions are either not retained or easily forgotten. Socio-cultural barriers make traditional top-down academic teaching, whether in clinic or a classroom setting, particularly ineffective [4,26]. For education to become a useful therapeutic tool, patients should be involved in hands-on activities, role-playing, problem-solving and other interactive techniques [27].…”

Effectiveness of Self-Management Training in Type 2 Diabetes

“…Few studies had follow-up periods longer than 1 year after the last intervention contact, and these showed mixed effects on glycemic control. The positive studies were either very intensive interventions (79) or had a high attrition rate, leaving a very select group at follow-up (28). Studies with prolonged interventions (follow-up periods Ͼ1 year and regular contacts with the intervention subjects during that time) also had mixed results.…”

Impact of a Program to Improve Adherence to Diabetes Guidelines by Primary Care Physicians

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