The Treatment Effect of Education on the Metabolic Status of Type-2 Diabetic Patients

Overview

The aim of our project was to test the effect of an ambulatory group therapeutic and educationalcourse for Type-2 diabetic patients in the Diabetes Center on the patients’ metabolic status. Inthe first year, 35 diabetics with a mean age 58 ± 10 (35 - 79) years and mean diabetes durationof 8.5 ± 7.7 years took part in the course. The course was headed by an educational team. Thepatients had four half-day ambulatory sessions each week over a one-month period. After thecourse, there was a statistically significant decrease in body mass index (BMI, from 31,8 ± 6.2to 31.4 ± 6.2 kg/m 2 , p < 0.001) and a decrease in glycosylated hemoglobin Hb1c (from 7.8 ± 1.7to 7.6 ± 1.7%, p < 0.001). There were also a statistically significant improvement in the lipidspectrum; reductions in the levels of cholesterol (from 6.1 ± 1.2 to 5.7 ± 1.9 mmol/L; p < 0.01)and triglycerides (from 2.8 ± 1.8 to 2.5 ± 1.8 mmol/L; p < 0.05); HDL cholesterol did not changestatistically significantly (1.1 ± 0.3 mmol/L before and after the course). Systolic blood pressuredeclined statistically significantly (from 143 ± 21 to 137 ± 17 mmHg; p < 0.05) while there wasno significant change in diastolic blood pressure (83 ± 14 vs 81 ± 12 mmHg). Uric acid levelsalso did not change significantly; however, they were within the normal range already beforethe course (273 ± 75 vs 277 ± 75 mmol/L). The above beneficial metabolic changes during theeducational course were due mainly to a change in diet (reduction in total energy intake by 163kcal/day; p < 0.05) and increased rates of self-monitoring of glycemia (from 29 to 69% of patients;p < 0.001) and glycosuria (from 17 to 60% of patients; p < 0.01). Educational courses in DiabetesCenters may aid, in a most effective manner, in the treatment of the metabolic syndrome inType-2 diabetic patients; however, motivation of patients and health-care professionals to thistechnique of management remains a problem.

Key words:
diabetes mellitus - education - metabolic status.