Two points I wish to make in this blog
are:
The first point = People with diabetes
who receive education and training at clinical appointments had a 49
percent greater likelihood of achieving long term blood glucose
management than patients not receiving any education.
The second point = Doctor training
about diabetes management seemed to be ineffective in helping
patients manage their glucose levels
The study outlining the above two
points was published in Ethnicity and Disease. The
researchers were expecting that the physician training would yield a
better or an equal outcome to the education with the patient, but
that did not happen. I do understand why providing intensive
diabetes training to physicians did not work. Doctors do not get
paid for providing diabetes education and under the current payment
system, they will not provide diabetes education to patients for
free.
Teaching people with diabetes how to
manage their blood glucose levels helps them achieve better results.
This happens because they are stakeholders and diabetes directly
affects them. In addition, they spend about one hour per year with
the doctor and must manage their diabetes 24/7/365.
This study happened in the Baltimore
area and the findings are from 823 mostly Black patients with
diabetes treated between April 2005 and July 2007. The patients,
each treated by one of ten primary care physicians, were randomized
into four groups.
The participants in the study were
divided into four groups.
The first group received special
diabetes counseling with a nurse during office visits.
The second group did not receive
counseling, but was treated by five physicians who received diabetes
training.
The third group received counseling and
was treated by physicians who received training.
The fourth group received no training
and their five physicians received no training.
The patients were seen every six months
and improvement was measured by evaluating the reduction in HbA1c
results. The patients receiving counseling sessions with a nurse at
each office visit increased their chances of long-term blood glucose
management by 49 percent after two years compared the group in which
neither the patients nor the physicians received training. The
physician training seemed ineffective at managing the patients' blood
glucose levels.
The surprising unmentioned item is that
self-monitoring of blood glucose after the completion of the study
and what this may have accomplished.
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