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Evaluation of the effectiveness of an ambulatory teaching/treatment programme for non-insulin dependent (type 2) diabetic patients

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Abstract

The aim of this study was to evaluate the effect of a structured teaching/treatment programme on the clinical and metabolic control of non-insulin-dependent (type 2) diabetic patients. The programme was aimed at improving the overall treatment quality in these patients through measures involving self-care, diet, exercise and weight reduction. Four theoretical-practical teaching units were given once a week to group of 5–8 ambulatory patients by previously trained general practitioners. Clinical and biochemical parameters were recorded at the beginning of the course and 1 year after its completion in 40 patients attending the programme and in 39 patients of similar clinical characteristics under conventional diabetes treatment, but receiving no structured teaching before or during the survey period (control group). The drop-out percentage in the intervention group (25%) was significantly lower than in the control group (45%),P<0.05, suggesting an incentive toward greater compliance in the former. At the end of the 1-year follow-up, the mean differences observed in the control and in the intervention groups were: body weight loss −2.4±0.5 kg vs −0.4±0.5 (P<0.001); haemoglobin HbA1 −0.2%±0.4% vs +0.8±0.4% (NS); number of daily oral hypoglycaemic agent intake −1.4±0.2 vs +0.9±0.2 tablets (P<0.001). Our results strongly suggest that this programme, applied through family doctors, may constitute an efficient tool to improve the compliance and clinico-metabolic control of type 2 patients at the primary health care level.

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References

  1. De Fronzo R, The trimuvirate: β-cell, muscle, liver: a collusion responsible for NIDDM. Diabetes 37:667–698, 1988

    PubMed  Google Scholar 

  2. Campbell P, Carlson MC, Impact of obesity on insulin action in NIDDM. Diabetes 42:405–410, 1993

    PubMed  Google Scholar 

  3. Bjorntorp P, Abdominal obesity and the metabolic syndrome. Ann Med 24:465–468, 1994

    Google Scholar 

  4. Kahn CR, Insulin action, diabetogenes and the cause of type II diabetes. Diabetes 43:1066–1084, 1993

    Google Scholar 

  5. Berger M, Grüsser M, Jörgens V, Standl E, Mehnert H, and Boehringer Mannheim, Diabetes Treatment in our Practice: Education and Treatment Program for Non-insulin-treated Type II Diabetic Patients. Deutscher Ärzte-Verlag, Köln; 1987

    Google Scholar 

  6. European NIDDM Policy Group, Desktop guide for the management of non-insulin-dependent diabetes mellitus (NIDDM). Bull Int Diabetes Fed 35:2–23, 1990

    Google Scholar 

  7. Kronsbein P, Jorgens V, Mülhauser I, Scholz V, Venhaus A, Berger M, Evaluation of structured treatment and teaching programmes on non-insulin dependent diabetes. Lancet 2:1407–1410, 1988

    Article  PubMed  Google Scholar 

  8. Savage PJ, Bennion LJ, Flock EV, Nagulesparan M, Mott D, Roth J, Unger RH, Bennett PH, Diet-induced improvement of abnormalities in insulin and glucagon secretion and in insulin receptor binding in diabetes mellitus. J Clin Endocrinol Metab 48:999–1007, 1979

    PubMed  Google Scholar 

  9. Beck-Nielsen H, Pedersen O, Sorensen NS, Effects of dietary changes on cellular insulin binding and in vivo insulin sensitivity. Metabolism 29:482–487, 1980

    Article  PubMed  Google Scholar 

  10. Wales JK, Treatment of type 2 (NID) diabetic patients with diet alone. Diabetologia 23:240–245, 1982

    Article  PubMed  Google Scholar 

  11. Henry RR, Wallace P, Olefsky JM, Effect of weight loss on mechanisms of hyperglycemia in obese non-insulin dependent diabetes mellitus. Diabetes 35:990–998, 1986

    PubMed  Google Scholar 

  12. Bitzén PO, Melander A, Scherstén M, Svensson M, Efficacy of dietary regulation in primary health care patients with hyperglycaemia detected by screening. Diabetic Med 5:640–647, 1988

    PubMed  Google Scholar 

  13. UKPDS Group, Prospective Diabetes Study 7: response of fasting plasma glucose to diet therapy in newly presenting type II diabetic patients. Metabolism 39:905–912, 1990

    Google Scholar 

  14. Taboulet F, Comparaison Internationale de Consommations Pharmaceutiques (These). Université Claude Bernard, Lyon; 1991 (No. 17, 91)

    Google Scholar 

  15. Groop L, Sulfonylureas in NIDDM. Diabetes Care 15:737–753, 1992

    PubMed  Google Scholar 

  16. Asplund K, Wiholm BE, Lithner F, Glibenclamide associated hypoglycaemia: a report on 57 cases. Diabetologia 24:412–417, 1983

    Article  PubMed  Google Scholar 

  17. Gruesser M, Bott U, Ellermann P, Kronsbein P, Jorgens V, Evaluation of a structured treatment and teaching program for noninsulin-treated type II diabetic outpatients in Germany after the nationwide introduction of reimbursement policy for physicians. Diabetes Care 16:1268–1275, 1993

    PubMed  Google Scholar 

  18. Gagliardino JJ, Olivera EM, Barragán H, Puppo RA, A simple economic evaluation model for selecting diabetes health care strategies. Diabetic Med 10:351–354, 1993

    PubMed  Google Scholar 

  19. Olivera EM, Perez Duhalde E, Gagliardino JJ, Cost of temporary and permanent disability induced by diabetes. Diabetes Care 14:593–596, 1991

    PubMed  Google Scholar 

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Domenech, M.I., Assad, D., Mazzei, M.E. et al. Evaluation of the effectiveness of an ambulatory teaching/treatment programme for non-insulin dependent (type 2) diabetic patients. Acta Diabetol 32, 143–147 (1995). https://doi.org/10.1007/BF00838482

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  • DOI: https://doi.org/10.1007/BF00838482

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