Diabetes Metab J.  2017 Jun;41(3):187-194. 10.4093/dmj.2017.41.3.187.

Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes

• Kim HS
• Kim H
• Yang HK
• Lee EY
• Jeong YJ
• Kim TM
• Yang SJ
• Baik SY
• Lee SH
• Cho JH
• Choi IY
• Yim HW
• Cha BY

• KMID: 2392493
• DOI: http://doi.org/10.4093/dmj.2017.41.3.187

Abstract

BACKGROUND
When patients with diabetes mellitus (DM) are first referred to a hospital from primary health care clinics, physicians have to decide whether to administer an oral hypoglycemic agent (OHA) immediately or postpone a medication change in favor of diabetes education regarding diet or exercise. The aim of this study was to determine the effect of diabetes education alone (without alterations in diabetes medication) on blood glucose levels.
METHODS
The study was conducted between January 2009 and December 2013 and included patients with DM. The glycosylated hemoglobin (HbA1c) levels were evaluated at the first visit and after 3 months. During the first medical examination, a designated doctor also conducted a diabetes education session that mainly covered dietary management.
RESULTS
Patients were divided into those who received no diabetic medications (n=66) and those who received an OHA (n=124). Education resulted in a marked decrease in HbA1c levels in the OHA group among patients who had DM for <1 year (from 7.0%±1.3% to 6.6%±0.9%, P=0.0092) and for 1 to 5 years (from 7.5%±1.8% to 6.9%±1.1%, P=0.0091). Those with DM >10 years showed a slightly lower HbA1c target achievement rate of <6.5% (odds ratio, 0.089; P=0.0024).
CONCLUSION
For patients who had DM for more than 5 years, higher doses or changes in medication were more effective than intensive active education. Therefore, individualized and customized education are needed for these patients. For patients with a shorter duration of DM, it may be more effective to provide initial intensive education for diabetes before prescribing medicines, such as OHAs.

Keyword

Blood glucose; Diabetes education; Diabetes mellitus; Health educators; Hemoglobin A, glycosylated

MeSH Terms

Blood Glucose
Diabetes Mellitus
Diet
Education*
Health Educators
Hemoglobin A, Glycosylated
Humans
Primary Health Care
Blood Glucose
Hemoglobin A, Glycosylated

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