[Withdrawal of a specialised diabetes education program in primary care: long term impact on the metabolic control outcomes].
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.
Jurado Campos
Jerónimo
J
Instituto Catalán de la Salud, EAP Olot, Girona, España. jjurado.girona.ics@gencat.cat
Caula Ros
Jacint A
JA
Hernández Anguera
Josep M
JM
Juvinyà Canal
Dolors
D
Pou Torelló
José M
JM
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