Subject    :    [2017 Jun;41(3)] Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
Writer KDA
Date 2017-07-06 11:09:34 Hit 8,421

 
Diabetes Metab J. 2017 Jun;41(3):187-194. English.
Published online May 12, 2017.  https://doi.org/10.4093/dmj.2017.41.3.187 
Copyright © 2017 Korean Diabetes Association
   
Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
Hun-Sung Kim,1,2,* Hyunah Kim,3,* Hae-Kyung Yang,2 Eun Young Lee,2 Yoo Jin Jeong,1 Tong Min Kim,1 So Jung Yang,1 Seo Yeon Baik,1 Seung-Hwan Lee,2 Jae Hyoung Cho,2 In Young Choi,1 Hyeon Woo Yim,4 and Bong-Yun Cha2
1Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
2Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
3Sookmyung Women's University College of Pharmacy, Seoul, Korea.
4Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Corresponding author: Bong-Yun Cha. Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 06591, Korea. Email: bycha@catholic.ac.kr

 

*Hun-Sung Kim and Hyunah Kim contributed equally to this study as first authors.
 
Received September 27, 2016; Accepted January 18, 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
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  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  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.

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

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