The effects of education with printed material on glycemic control in patients with diabetes type 2 treated with different therapeutic regimens

Abstract

Background/Aim. Diabetes mellitus (DM) is considered to be an epidemic, chronic and progressive disease. The treatment of DM reqiures substantial effort from both the diabetes treatment team and a patient. Patient education is one of the treatment elements. The most efficacious form and content of education has not yet been established. However, every DM education must include introduction to a substantial number of facts about diabetes. The aim of our study was to estimate the levels of DM knowledge and glycemic control in Serbian patients with DM type 2 as well as to estimate the effects of education using printed material on the levels of glycemic control and knowledge about DM. Also, the effects of education on glycemic control and the level of knowledge in differently treated patients were estimated. Methods. The patients with DM type 2 (n = 364), aged 40 to 65 years, from three regional health centers, were randomized for the study. After informed consent, patients filled out the questionnaire, and were checked for HbA1c and fasting blood glucose. Finally, booklet ?Healthy lifestyle with diabetes mellitus type 2? was given to them. The same procedure was repeated after 3, 6 and 18 months. Results. There was a significant improvement in HbA1c levels after 3 months (8.00 ? 1.66% vs 9.06 ? 2.23%, p < 0.01) and after 6 months (7.67 ? 1.75% vs 9.06 ? 2.23%, p < 0.01). There was no further improvement in HbA1c levels after 18 months (7.88 ? 1.46% vs 7.67 ? 1.75%, p > 0.05). There was a significant improvement in the average test score (percent of correct answers per test sheet) after three monts (64.6% vs 55.6%, p < 0.01). There were no further statistically significant changes in the general level of DM knowledge after 6 months (65.0 ? 32.5% vs 64.5 ? 33.7%, p > 0.05 ) and after 18 months ( 64.8 ? 32.7 vs 64.5 ? 33.7%, p > 0.05). There was a significant difference in educational intervention response in DM type 2 patients on different therapeutic regimens. Conclusion. Education with printed material led to improvement in glycemic control and level of DM knowledge in our patients. Education with printed material may be a useful adjunct to DM treatment and should be structured according to the treatment modality.Uvod/Cilj. Dijabetes melitus (DM) tip 2 je hronicno progresivno oboljenje epidemijskog karaktera. Lecenje DM zahteva potpunu posvecenost medicinskog tima, ali i bolesnika. Informisanje bolesnika jedan je od faktora u lecenju ove bolesti, a efikasna forma i sadrzaj informisanja ni danas nisu jasno odredjeni. Poznavanje cinjenica o DM je neophodni sadrzaj svake edukacije. Cilj naseg rada bio je da procenimo nivo glikemijske kontrole i nivo poznavanja cinjenica o DM kod nasih bolesnika sa DM tip 2, kao i efekat informisanja stampanim materijalom na nivo glikemijske kontrole kod bolesnika lecenih razlicitim terapijskim modalitetima. Metode. Bolesnici sa DM tip 2 (n = 364), starosti od 40 do 65 godina, na redovnim kontrolama u regionalnim centrima za lecenje DM potpisali su posle informisanja pristanak i ispunili upitnik. Mereni su im HbA1c i glikemija naste, nakon cega su dobili stampani materijal - brosuru "Zdrav zivot sa dijabetesom". Procedura je ponovljena posle 3, 6 i 18 meseci. Rezultati. Doslo je do statisticki znacajnog poboljsanja nivoa HbA1c nakon 3 meseca (8,00 ? 1,66 vs 9,06 ? 2,23%, p < 0,01) i nakon 6 meseci (7,67 ? 1,75 vs 9,06 ? 2,23%, p < 0,01). Nakon 18 meseci nije doslo do daljeg snizenja nivoa HbA1c (7,88 ? 1,46% vs 7,67 ? 1,75%, p > 0,05). Test skor (prosecan broj trazenih tacnih odgovora) znacajno je poboljsan nakon 3 meseca (64,6% vs 55,6%, p < 0,01). Posle 6 i 18 meseci nije bilo znacajnih promena u broju tacnih odgovora (6 meseci: 65,0 ? 32,5% vs 64,5 ? 33,7%, p > 0,05; 18 meseci: 64,8 ? 32,7% vs 64,5 ? 33,7%, p > 0,05). Ustanovljena je znacajna razlika u odgovoru na pitanja o DM kod bolesnika sa razlicitim terapijskim rezimima. Zakljucak. Informisanje stampanim materijalom bez uticaja instruktora dovelo je do poboljsanja glikemijske kontrole kod nasih ispitanika. Nivo poznavanja pojedinih cinjenica o DM znacajno je poboljsan. Ovaj tip informisanja korisna je dopunska intervencija u lecenju DM. Sadrzaj informisanja treba prilagoditi terapijskom rezimu bolesti.