Adherence to two methods of education and metabolic control in type 2 diabetics

Abstract

BACKGROUND: Education in diabetes optimizes metabolic control, prevents acute and chronic complications, and improves quality of life. Our main objective was to evaluate if a better metabolic control is achieved in diabetic patients undergoing a program of intensive interactive care than in those with traditional care and written information. METHODS: Patients with type 2 diabetes mellitus (T2DM), aged 20-60 years, education level at least of primary school, serum creatinine ≤ 2.5 mg/dl, self-sufficient and HbA1c ≥ 7.1% were allocated in two groups of education, 1) minimal education (MEG) and 2) full education (FEG). The MEG patients followed predefined diet; FEG patients chose the diet by selecting foods from each group in a list of matches, teaching them to count nutrients, kilocalories (kcal) and percentage of nutrients. RESULTS: A follow-up of 31 patients in each group was obtained. The proportion of patients who had initial adherence was 13.33% in the MEG group and 9.67% in the FEG group while, at the end of the study, these percentages were of 73.3% and 58.38% respectively. The final HbA1c decreased in both groups, with or without good adherence. The FEG group had a higher decline in the values of cholesterol (p = 0.036) and LDL (p = 0.002) than the MEG group. CONCLUSION: Education programs in T2DM contribute to a decrease in HbA1c within six months, but an intensive program is more effective in reducing cholesterol and LDL. KEYWORDS: diabetes mellitus, education, metabolic control.