Evaluation of intensified therapeutic education in the prevention of type 2 diabetes in the outpatient care setting

Abstract

Introduction. WHO has recognized diabetes as a non-infectious epidemic disease. Due to the steady increase in the number of diabetic patients, a pandemic of this disease is expected to occur in the coming years. According to WHO estimates from 2016, the incidence of diabetes has quadrupled since 1980, currently amounting 422 million adults. According to the NATPOL PLUS study, at least 1.6 million Poles suffer from diabetes, and the incidence of type 2 diabetes is estimated at 5-6% of the entire Polish population. Although type 2 diabetes is considered to be a disease of the middle-Aged and seniors, the number of diabetic children and adolescents has grown in recent years. The risk factors for type 2 diabetes are commonly known and can be easily identified in the population. The research objective was to evaluate how effective selected therapeutic education methods provided for obese people are in the prevention of type 2 diabetes. Another aim was to assess the impact of such education on certain anthropometric and laboratory parameters in outpatient health care conditions. Material and methods. The study included 50 individuals who met the following inclusion criteria: Age ≥ 30, BMI ≥ 30, and no known blood glucose disorders reported in the interview. The participants were divided into 2 education groups: The intensive Group 1, subjected to education in the cycle of 0-1-2-3 months (four doctor's appointments), and the standard Group 2, educated in the cycle of 0-3 months (two doctor's appointments). For each participant, the following measurements were taken: height, body weight, and waist circumference. Also, each participant was subjected to two 75 g oral glucose tolerance tests (OGTT) with blood samples drawn at 0 and 120 min: one at the beginning of the intervention and another 3 months after receiving first health recommendations. Plasma insulin in OGTT and HOMA-IR index were also assessed. Results. Patients from Group 1 reduced their body weight by 9.6 ± 5.5 kg, whereas in the case of Group 2 it was 3.6 ± 6.0 kg (p < 0.01). The percentage of patients with normal/abnormal glucose tolerance changed from 29/71 to 58/42 in Group 1, and from 18/82 to 32/68 in Group 2 (p < 0.05). Conclusions. By increasing the number of medical appointments focused on healthy lifestyle advice in type 2 diabetes prevention in obese outpatients from two to four, it is possible to achieve more effective weight loss, to improve metabolic parameters, and to normalize glucose disorders.