Effectiveness of Systematic Health Education Model for Type 2 Diabetes Patients

Background Health education is considered to be essential in the overall care of patients with type 2 diabetes mellitus (T2DM); systematic health education integrates individual education not only during hospitalization but also extended care outside of a hospital. To test effectiveness of the systematic health education model for T2DM, we conducted a randomized study with a control group among patients with T2DM living in Nanjing, China. Methods 998 eligible patients completed the enrollment and were randomized to systematic health education model and conventional model groups (498 and 500 patients, resp.). The systematic health education model was based on the following aspects: image education, visitation of the exhibition hall, dissemination of educational materials, individualized medical nutrition therapy and exercise programs, WeChat group and regular health lectures, evaluation of complications, lifestyle modification, systematic treatment scheme, self-monitoring of glycemic control, monthly evaluation of the therapeutic effect, proposed improvement measures, and individualized follow-up scheme. The main outcome measures were glycated hemoglobin A1c (HbA1c), blood pressure, body mass index (BMI), and lipids during the 2-year follow-up. Results The systematic health education model led to a favorable variation in HbA1c, LDL cholesterol, and systolic blood pressure (SBP) (P < 0.05). After adjusted analysis, the HbA1c decreased by 0.67% (P < 0.01) in the systematic health education model, SBP decreased by 10.83 mmHg (P < 0.01), and the level of diastolic blood pressure (DBP), HDL cholesterol, and total cholesterol decreased slightly and was not significant. The BMI did not change significantly during the study in either of the two groups. Conclusions The systematic health education model is a useful method in the treatment of T2DM because it contributes to decrease in HbA1c, LDL cholesterol, and SBP levels, as well as helps in increasing the compliance with the control criteria, except for DBP and BMI.

[1]  Jing Wang,et al.  2017 National Standards for Diabetes Self-Management Education and Support , 2017, Diabetes Care.

[2]  R. Holman,et al.  Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) , 1998, The Lancet.

[3]  Diederick Grobbee,et al.  Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. , 2008, The New England journal of medicine.

[4]  M. Porta,et al.  Rethink Organization to iMprove Education and Outcomes (ROMEO) , 2010, Diabetes Care.

[5]  G. McMahon,et al.  A Team-Based Online Game Improves Blood Glucose Control in Veterans With Type 2 Diabetes: A Randomized Controlled Trial , 2017, Diabetes Care.

[6]  Z. Niazkhani,et al.  Effects of Face-to-Face and Telephone-Based Family-Oriented Education on Self-Care Behavior and Patient Outcomes in Type 2 Diabetes: A Randomized Controlled Trial , 2017, Journal of diabetes research.

[7]  E. Pau,et al.  Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes mellitus , 2011, BMC public health.

[8]  T. Kadowaki,et al.  Effectiveness of lifestyle counseling by certified expert nurse of Japan for non-insulin-treated diabetic outpatients: a 1-year randomized controlled trial. , 2007, Diabetes research and clinical practice.

[9]  C. Schmid,et al.  Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control. , 2002, Diabetes care.

[10]  M. Porta,et al.  A 5-year randomized controlled study of learning, problem solving ability, and quality of life modifications in people with type 2 diabetes managed by group care. , 2004, Diabetes care.

[11]  Robert R. Henry,et al.  Type 2 diabetes mellitus , 2015, Nature Reviews Disease Primers.

[12]  J. Gallivan,et al.  The National Diabetes Education Program at 20 Years: Lessons Learned and Plans for the Future , 2018, Diabetes Care.

[13]  R. Holman,et al.  Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. , 1998 .

[14]  John D. Piette,et al.  National Standards for Diabetes Self-Management Education , 2011, Diabetes Care.

[15]  Uk-Prospective-Diabetes-Study-Group.  Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) , 1998, The Lancet.

[16]  Rachel H. Greenberg,et al.  The National Diabetes Education Program Evaluation Framework: How to Design an Evaluation of a Multifaceted Public Health Education Program , 2008, Preventing chronic disease.

[17]  S. Boren,et al.  Costs and Benefits Associated With Diabetes Education A Review of the Literature , 2009, The Diabetes educator.

[18]  L. McClure,et al.  Comprehensive evaluation of community-based diabetic patients: effect of feedback to patients and their physicians: a randomized controlled trial. , 2001, Diabetes care.

[19]  Konrad Jamrozik.  Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies , 2002 .

[20]  Stephen Colagiuri,et al.  Individual patient education for people with type 2 diabetes mellitus. , 2009, The Cochrane database of systematic reviews.

[21]  R. Collins,et al.  Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies , 2002, The Lancet.

[22]  P. Conlin,et al.  A randomized trial comparing intensive and passive education in patients with diabetes mellitus. , 2002, Archives of internal medicine.

[23]  O. Ziegler,et al.  From therapeutic patient education principles to educative attitude: the perceptions of health care professionals – a pragmatic approach for defining competencies and resources , 2017, Patient preference and adherence.

[24]  J. Gross,et al.  A Structured Educational Program Improves Metabolic Control in Patients With Type 2 Diabetes , 2009, The Diabetes educator.

[25]  D. Schillinger,et al.  State of Diabetes Self-Management Education in the European Union Member States and Non-EU Countries: The Diabetes Literacy Project , 2018, Journal of diabetes research.

[26]  S. Schinner,et al.  Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes , 2009 .