Targeting educational therapy for type 2 diabetes: identification of predictors of therapeutic success

Patient education is a key component of diabetes care. Limits in resources often prevent the participation of many patients with type 2 diabetes to structured education programs. The identification of predictors of response to group education could help in selecting those patients in whom the interv...

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Published in:Acta diabetologica 2013-06, Vol.50 (3), p.309-317
Main Authors: da Vico, Letizia, Monami, Matteo, Biffi, Barbara, Lamanna, Caterina, Martelli, Chiara, Marchionni, Niccolò, Mannucci, Edoardo
Format: Article
Language:English
Subjects:
Aged
Body Mass Index
Cholesterol, Dietary - administration & dosage
Counseling - methods
Counseling - organization & administration
Diabetes
Diabetes Mellitus, Type 2 - diet therapy
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - psychology
Dietary Proteins - administration & dosage
Drug therapy
Feeding Behavior
Female
Follow-Up Studies
Glycated Hemoglobin A - metabolism
Health education
Humans
Hypoglycemic Agents - therapeutic use
Internal Medicine
Male
Medicine
Medicine & Public Health
Metabolic Diseases
Middle Aged
Original Article
Patient Education as Topic - methods
Patient Education as Topic - organization & administration
Predictive Value of Tests
Program Evaluation
Prospective Studies
Self Care - methods
Treatment Outcome
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container_title Acta diabetologica
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creator da Vico, Letizia
Monami, Matteo
Biffi, Barbara
Lamanna, Caterina
Martelli, Chiara
Marchionni, Niccolò
Mannucci, Edoardo
description Patient education is a key component of diabetes care. Limits in resources often prevent the participation of many patients with type 2 diabetes to structured education programs. The identification of predictors of response to group education could help in selecting those patients in whom the intervention is more cost-effective. A structured interactive group program was proposed to a consecutive series of 150 type 2 diabetes patients, who were then followed prospectively in 24 months, with measurements of HbA1c, BMI, quality of life, eating habits. For comparison, another consecutive series of 113 patients who had received no intervention was also observed for 12 months. A significant reduction in HbA1c was observed in the intervention group at 12 and 24 months (from 7.5 ± 1.4 to 6.9 ± 1.2 and 6.6 ± 1.1% at 12 and 24 months, respectively, both P  
doi_str_mv 10.1007/s00592-012-0377-2
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Limits in resources often prevent the participation of many patients with type 2 diabetes to structured education programs. The identification of predictors of response to group education could help in selecting those patients in whom the intervention is more cost-effective. A structured interactive group program was proposed to a consecutive series of 150 type 2 diabetes patients, who were then followed prospectively in 24 months, with measurements of HbA1c, BMI, quality of life, eating habits. For comparison, another consecutive series of 113 patients who had received no intervention was also observed for 12 months. A significant reduction in HbA1c was observed in the intervention group at 12 and 24 months (from 7.5 ± 1.4 to 6.9 ± 1.2 and 6.6 ± 1.1% at 12 and 24 months, respectively, both P  &lt; 0.01), with no variation in BMI and quality of life. A sustained reduction in total energy, protein, and fat intake was observed after education. The proportion of success (HbA1c &lt; 7% and/or HbA1c reduction from baseline &gt; 1%) in the intervention group was 60.7% (vs. 38.1% in controls) and 63.3% at 12 and 24 months, respectively. In the intervention group, patients with success at 12 months showed lower baseline HbA1c, BMI, duration of diabetes, protein, and cholesterol intake. Patients with a lower duration of diabetes appear to have a greater response to structured group education, whereas age is not a predictor of response. 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The proportion of success (HbA1c &lt; 7% and/or HbA1c reduction from baseline &gt; 1%) in the intervention group was 60.7% (vs. 38.1% in controls) and 63.3% at 12 and 24 months, respectively. In the intervention group, patients with success at 12 months showed lower baseline HbA1c, BMI, duration of diabetes, protein, and cholesterol intake. Patients with a lower duration of diabetes appear to have a greater response to structured group education, whereas age is not a predictor of response. Therefore, educational intervention should be planned in the earlier phases of the disease.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>22350098</pmid><doi>10.1007/s00592-012-0377-2</doi><tpages>9</tpages></addata></record>
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1432-5233
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source Springer Nature
subjects Aged
Body Mass Index
Cholesterol, Dietary - administration & dosage
Counseling - methods
Counseling - organization & administration
Diabetes
Diabetes Mellitus, Type 2 - diet therapy
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - psychology
Dietary Proteins - administration & dosage
Drug therapy
Feeding Behavior
Female
Follow-Up Studies
Glycated Hemoglobin A - metabolism
Health education
Humans
Hypoglycemic Agents - therapeutic use
Internal Medicine
Male
Medicine
Medicine & Public Health
Metabolic Diseases
Middle Aged
Original Article
Patient Education as Topic - methods
Patient Education as Topic - organization & administration
Predictive Value of Tests
Program Evaluation
Prospective Studies
Self Care - methods
Treatment Outcome
title Targeting educational therapy for type 2 diabetes: identification of predictors of therapeutic success
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