Influence of organized diabetic education on self-control and quality of life of patients with type 2 diabetes

Abstract

The aim of the study was to evaluate dietary habits, lifestyle, and quality of life (QoL) of type 2 diabetes patients. We assumed that patients participating in post-hospital treatment and arranged program of diabetic education along with rehabilitation would in effect obtain better control of disease symptoms, use their knowledge on disease regimens and dangers in practice as well as would evaluate their QoL higher when compared to patients treated in a traditional way by a family doctor and getting only advice concerning the change of lifestyle. Participation of patients in the study was voluntary, and every enrolled patient gave his informed consent prior to entering the study. The only inclusion criteria were simple: a type 2 diabetic patient hospitalized due to complications caused by diabetes not longer than 10 days before entering the study. Exclusion criteria included previous participation in a program of post-hospital sanatorium treatment, uncontrolled diabetes, any diabetic complication requiring surgical intervention, severe cases of polyneuropathy or vegetative neuropathy, nephropathies with uremia, and circulatory insufficiency (NYHA >II). Three hundred eighteen patients with diabetes were enrolled. They were assigned to two groups: group I (n = 156)—type 2 diabetes patients assigned to a post-hospital sanatorium treatment and group II (n = 162)—type 2 diabetes patients treated after leaving hospital by family doctor. The post-hospital program of sanatorium treatment attended by group I patients lasted 21 days and included group educational classes with information on diabetes pathophysiology; genetic and environmental conditionings of diabetes; techniques of self-control of glycemia level, cholesterol, and arterial blood pressure; importance of physical activity and appropriate diet; reduction of body mass; obeying doctor’s advice; giving up smoking; and discussion of late complications resulting from incorrect treatment of type 2 diabetes. The education program of patients treated by a family doctor consisted of two 30-min meetings with a nurse-diabetology educator during which she talked to patients about the pathophysiology of diabetes, self-control, late complications, and foot care as well as of two 30-min meetings with a dietician who discussed the rules of healthy lifestyle. Organized diabetic education conducted during post-hospital sanatorium treatment positively affects lifestyle changes, self-control abilities, and at the same time assessment of QoL in type 2 diabetes patients. All type 2 diabetes patients evaluate their QoL as the lowest within the scope of physical health; this evaluation is still much lower in patients under regular family doctor’s care than in those who underwent group education in after-sanatorium treatment.