Patients' education, and its impact on care outcomes, resource consumption and working conditions: data from the International Diabetes Management Practices Study (IDMPS).
OBJECTIVE
To evaluate the impact of diabetes education provided to patients with type 2 diabetes mellitus (T2DM) in non-controlled studies ("real-world conditions") on quality of care, resource consumption and conditions of employment.


METHODS
This cross-sectional study and longitudinal follow-up describe the data (demographic and socioeconomic profiles, clinical characteristics, treatment of hyperglycaemia and associated cardiovascular risk factors, resource consumption) collected during the second phase (2006) of the International Diabetes Management Practices Study (IDMPS). Patients received diabetes education directly from the practice nurse, dietitian or educator, or were referred to ad hoc group-education programmes; all programmes emphasized healthy lifestyle changes, self-care and active participation in disease control and treatment. Educated vs non-educated T2DM patients (n=5692 in each group), paired by age, gender and diabetes duration, were randomly recruited for the IDMPS by participating primary-care physicians from 27 countries in Eastern Europe, Asia, Latin America and Africa. Outcome measures included clinical (body weight, height, waist circumference, blood pressure, foot evaluation), metabolic (HbA(1c) levels, blood lipid profile) and biochemical control measures. Treatment goals were defined according to American Diabetes Association guidelines.


RESULTS
T2DM patients' education significantly improved the percentage of patients achieving target values set by international guidelines. Educated patients increased their insulin use and self-care performance, had a lower rate of chronic complications and a modest increase in cost of care, and probably higher salaries and slightly better productivity.


CONCLUSIONS
Diabetes education is an efficient tool for improving care outcomes without having a major impact on healthcare costs.
Center of Experimental and Applied Endocrinology, La Plata National Scientific and Technical Research Council-La Plata National University, PAHO/WHO Collaborating Centre for Diabetes, La Plata, Argentina. cenexa@speedy.com.ar
J J
JJ
Gagliardino
P
P
Aschner
S H
SH
Baik
J
J
Chan
J M
JM
Chantelot
H
H
Ilkova
A
A
Ramachandran
D000349:Africa / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data*; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D012648:Self Care / Q000706:statistics & numerical data*
D001786:Blood Glucose