Long-term Impact of a Structured Group-based Inpatient-education Program for Intensive Insulin Therapy in Patients with Diabetes Mellitus

Overview

Journal Wien Klin Wochenschr

Publisher Springer

Specialty General Medicine

Date 2010 Jun 26

PMID 20577823

Citations 2

Authors

Christian S Gobl

Barbara Dobes

Anton Luger

Martin G Bischof

Michael Krebs

Affiliations

Soon will be listed here.

Abstract

Purpose: Structured patient education aiming to improve self-management strategies might be beneficial for insulin-treated diabetic patients. However, in previous studies the extent of the benefit has been inconsistent in different subgroups of patients. The aim of the present study was to assess the potential benefit of a structured inpatient-education program for intensive insulin therapy according to the basal-bolus concept with particular emphasis on self-management strategies.

Methods: We included 81 diabetic patients (59 with type 1, 14 with type 2, eight with other forms) in this retrospective longitudinal study; all had completed the training program on eight consecutive days at a university clinic between 2003 and 2005. Data assessment included HbA1c, LDL-cholesterol, HDL-cholesterol and BMI at baseline (0-15 months before the training) and after 0-5, 5-10 and 10-20 months.

Results: A transient decrease of HbA1c (0.2%, 95% CI: 0.04-0.37, P = 0.017) and LDL-cholesterol levels (9.95 mg/dl, 95% CI: 2.24-17.76, P = 0.013) between baseline and the first follow-up examination was observed in the group overall. Thereafter, HbA1c and LDL-cholesterol were similar to baseline, whereas a persistent increase in HDL-cholesterol (P = 0.025) was evident in the multivariable analysis. No changes in BMI were observed. A significant type-by-time interaction (P = 0.008) in HbA1c suggests a long-term benefit in glycemic control in patients with type 2 diabetes.

Conclusion: A diabetes training program for intensive insulin therapy with particular emphasis on self-management skills was followed by a moderate and transient improvement of glycemic control and LDL-cholesterol and by a persistent increase in HDL-cholesterol. Long-term improvement in glycemic control was observed only in patients with type 2 diabetes.

Citing Articles

Parental knowledge and metabolic control of children and young adults with type 1 diabetes.

Stefanowicz A, Mysliwiec M, Adamkiewicz-Drozynska E Arch Med Sci. 2018; 14(1):52-59.

PMID: 29379532 PMC: 5778408. DOI: 10.5114/aoms.2015.53832.

Impact of inpatient diabetes management, education, and improved discharge transition on glycemic control 12 months after discharge.

Wexler D, Beauharnais C, Regan S, Nathan D, Cagliero E, Larkin M Diabetes Res Clin Pract. 2012; 98(2):249-56.

PMID: 23036785 PMC: 3514591. DOI: 10.1016/j.diabres.2012.09.016.

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