July 17, 2014

Patient Education Helps Manage Diabetes

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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