title: [Withdrawal of a specialised diabetes education program in primary care: long term impact on the metabolic control outcomes].
abstract: OBJECTIVE
  To evaluate the possible relationships between a health policy decision, in relation to the diabetes education strategies and the metabolic control outcomes.
  
  
  METHODS
  Longitudinal prospective cohort study.
  
  
  METHODS
  A random cohort sample of 276 type II diabetes mellitus subjects.
  
  
  METHODS
  All primary care centres in three regions of Catalonia.
  
  
  METHODS
  Patients were classified as specialised (n=59) or non-specialised (n=217) groups, as regards whether having received previous diabetes education before the start of the study. HbA1c values were evaluated in all subjects at baseline and after 5 years after receiving only conventional education.
  
  
  RESULTS
  Baseline evaluation showed a better metabolic control in the specialised group (P=0.009). The final evaluation showed no significant differences in outcomes between the two groups (P=0.679). When baseline and outcomes values were compared, significant differences were observed in all subjects (P=0.001), the specialised group showed significantly poorer metabolic control (P<0.001), but in the group with previous conventional education no significant differences were observed (P=0.058).
  
  
  CONCLUSIONS
  Our results suggest that the withdrawal of higher levels of diabetes education may play a major role in poor metabolic control, and that conventional diabetes education does not improve outcomes. Health policy in Primary Care should consider improving the level of diabetes education.
authors.affiliation: Instituto Catalán de la Salud, EAP Olot, Girona, España. jjurado.girona.ics@gencat.cat
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Jurado Campos
authors.forename: Jacint A
authors.initials: JA
authors.lastname: Caula Ros
authors.forename: Josep M
authors.initials: JM
authors.lastname: Hernández Anguera
authors.forename: Dolors
authors.initials: D
authors.lastname: Juvinyà Canal
authors.forename: José M
authors.initials: JM
authors.lastname: Pou Torelló
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D011320:Primary Health Care; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome