Influence of the duration of diabetes on the outcome of a diabetes self-management education program.
BACKGROUND
Diabetes education and lifestyle modification are critical components in controlling blood glucose levels of people with type 2 diabetes. Until now, available data on the effectiveness of education with respect to the duration of diabetes are limited. We investigated whether adherence to lifestyle behavior modification prompted by diabetes education was influenced by the duration of diabetes.


METHODS
Two hundred and twenty-five people with type 2 diabetes were recruited for an intensive, collaborative, group-based diabetes education program with annual reinforcement. We divided the patients into two groups based on the duration of their diabetes prior to the education program (≤1 year [≤1Y] vs. ≥3 years [≥3Y]). Dietary habits, physical activity, and the frequency of blood glucose self-monitoring were evaluated with a questionnaire prior to education and at the follow-up endpoint.


RESULTS
The mean follow-up period was 32.2 months. The mean hemoglobin A1c (A1C) value was significantly lower in the ≤1Y group. Self-care behaviors, measured by scores for dietary habits (P=0.004) and physical activity (P<0.001), were higher at the endpoint in the ≤1Y group than in the ≥3Y group. Logistic regression analysis revealed that a longer diabetes duration before education was significantly associated with mean A1C levels greater than or equal to 7.0% (53 mmol/mol).


CONCLUSIONS
Diabetes duration influenced the effectiveness of diabetes education on lifestyle behavior modification and glycemic control. More-intense, regular, and sustained reinforcement with encouragement may be required for individuals with longstanding type 2 diabetes.
Division of Endocrinology & Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Seung-Hyun
SH
Ko
Sin-Ae
SA
Park
Jae-Hyoung
JH
Cho
Sun-Hye
SH
Ko
Kyung-Mi
KM
Shin
Seung-Hwan
SH
Lee
Ki-Ho
KH
Song
Yong-Moon
YM
Park
Yu-Bae
YB
Ahn