Informal diabetes education: impact on self-management and blood glucose control.
The purpose of this study was to determine if participation in screening clinics to detect and treat diabetes-related eye disease also led to informal patient learning that had an impact on self-management behavior and blood glucose control.



To evaluate the evidence for patient learning over time, the data of patients who returned as advised for 2 subsequent annual diabetes disease screenings were analyzed. Evaluation measures included medication use, self-management behavior, and hemoglobin A1c (A1C).



During the 2-year study period, the use of insulin increased by 37% at the first exam, 43% at the second exam, and 42% at the third exam (P = .02). No significant changes were found in the use of oral medication. Glucose self-monitoring also increased by 61% at the first exam, 71% at the second exam, and 76% at the third exam (P < .01). Mean A1C values for returning participants declined by 9.2% at the first exam, 8.9% at the second exam, and 8.6% at the third exam (P = .03).



The screening clinics had an educational impact associated with behavior change (improved self-management and glucose control) even though the clinics were not intended to produce such change. Therefore, caregivers should consider that patient learning can and should be part of every diabetes care encounter.
Gillard
Mary Lou
ML
The Department of Medical Education University of Michigan, University of Michigan Medical School, Ann Arbor (Mss Gillard, Nwankwo, and Oh, and Drs Fitzgerald and Anderson)
Nwankwo
Robin
R
The Department of Medical Education University of Michigan, University of Michigan Medical School, Ann Arbor (Mss Gillard, Nwankwo, and Oh, and Drs Fitzgerald and Anderson)
Fitzgerald
James T
JT
The Department of Medical Education University of Michigan, University of Michigan Medical School, Ann Arbor (Mss Gillard, Nwankwo, and Oh, and Drs Fitzgerald and Anderson)
Oh
Mary
M
The Department of Medical Education University of Michigan, University of Michigan Medical School, Ann Arbor (Mss Gillard, Nwankwo, and Oh, and Drs Fitzgerald and Anderson)
Musch
David C
DC
Ophthalmology and Visual Sciences  University of Michigan, University of Michigan Medical School, Ann Arbor
(Drs Musch and Johnson)|Epidemiology  University of Michigan, University of Michigan Medical School, Ann Arbor
(Dr Musch)
Johnson
Mark W
MW
Ophthalmology and Visual Sciences  University of Michigan, University of Michigan Medical School, Ann Arbor
(Drs Musch and Johnson)
Anderson
Robert
R
The Department of Medical Education University of Michigan, University of Michigan Medical School, Ann Arbor (Mss Gillard, Nwankwo, and Oh, and Drs Fitzgerald and Anderson)
D001741:Black or African American; D003930:Diabetic Retinopathy / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008824:Michigan; D008875:Middle Aged; D010353:Patient Education as Topic; D012648:Self Care