Long-term results of a diabetes education program. Effects on the metabolic control and clinical outcome of complications
Figuerola, D.; Reynals, E.; Micaló, T.; Levy, I.; Gomis, R.
Medicina Clinica 91(14): 525-529
1988
ISSN/ISBN: 0025-7753 PMID: 3216742 Document Number: 319124
The authors analyze the effect of a complete educational program (EDP) (at least 10 hours) on the metabolic control, the medical care and the complications of diabetics during a five year period. Two groups of diabetics (A and B, with 40 patients in each) were compared. They were receiving insulin therapy and they were comparable, at the onset of the study, regarding sex, age, occupation, educational level, toxic habits, type and duration of these disease, duration of insulin therapy, circumstances of diagnosis and level of metabolic control. Both groups were different regarding their adscription to EDP and their regular attendance to the controls: theses criteria were fulfilled by group A and totally or partially rejected by group B. The levels of glycosylated hemoglobin (HbA1) (9.3 .+-. 2.0 vs 11.1 .+-. 2.2%, p < 0.001) mean basal blood glucose (166.8 .+-. 71.6 vs 195.4 vs .+-. 61.6 mg/dl, p < 0.001), cholesterol (205.0 .+-. 33.3 vs 218.6 .+-. 41.7, p < 0.01) and triglycerides (135.8 .+-. 59.1 vs 176.3 .+-. 80.4, p < 0.001) were significantly lower in group A. The overall number of hospital days (402 vs 567, p < 0.001), the hospital admissions for acute decompensations (23 vs 37, p < 0.005) and the mean hospital days (8.2 .+-. 3.4 vs 10.5 .+-. 3.5 p < 0.001) were also less in group A. In spite of these results, the difference in the rate of long term complications at the end of the study did not reach the levels of statistical significance. The reduction in the costs of medical care was about 15.000 pesetas per patient and year. A higher frequence of urine self monitorization (p < 0.005), blood self monitorization (p < 0.005) and in the weighting of foodstuffs represents a higher compliance with therapy, and probably indicates one of the ways through which the group following EDP had achieved better results.