Effectiveness of an educational intervention on the management of type 2 diabetic patients hospitalized in Internal Medicine: results from the FADOI-DIAMOND study.
Appropriate management of hyperglycemia is crucial for patients with type 2 diabetes. Aim of the FADOI-DIAMOND study was to evaluate real-world management of type 2 diabetic patients hospitalized in Internal Medicine wards (IMW) and the effects of a standardized educational intervention for IMW staff. DIAMOND has been carried out in 53 Italian IMW, with two cross-sectional surveys interspersed with an educational program (PRE phase and POST phase). In PRE phase, each center reviewed the charts of the last 30 hospitalized patients with known type 2 diabetes. An educational program was conducted in each center by means of the "outreach visit," a face-to-face meeting between IMW staff and a trained external expert. Six months after, each center repeated the data collection (POST phase), specular to the PRE. A total of 3,167 patients were enrolled (1,588 PRE and 1,579 POST). From PRE phase to POST, patients with registered anthropometric data (54.1 vs. 74.9 %, p < 0.001) and in-hospital/recent measurement of glycated hemoglobin (48.2 vs. 61.4 %, p < 0.005) increased significantly. After educational program, more patients received insulin during hospitalization (68.3 vs. 63.6 %, p = 0.005). A more relevant variation in glycemia during hospitalization was observed in POST phase than PRE (-22.2 vs. -15.5 mg/dL, p < 0.001), without differences as for occurrence of hypoglycemia (12.3 vs. 11.9 %). A one-shot educational intervention led to persistent improvement in the management of hospitalized patients with type 2 diabetes and to significant better glycemic control. Further studies might evaluate the effectiveness of a more aggressive educational program, on both management and outcomes.
Department of Internal Medicine, Major Hospital "SS. Annunziata", ASL CN1, Savigliano, Italy.
Giovanni
G
Gulli
Stefania
S
Frasson
Vito
V
Borzì
Andrea
A
Fontanella
Marco
M
Grandi
Claudio
C
Marengo
Antonio
A
Nicolucci
Ruggero
R
Pastorelli
Bruno
B
Solerte
Adriano
A
Gatti
Francesco Cristiano
FC
Raimondo
Erminio
E
Bonizzoni
Gualberto
G
Gussoni
Antonino
A
Mazzone
Antonio
A
Ceriello
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology* / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007388:Internal Medicine; D007558:Italy; D008297:Male; D008875:Middle Aged
D006442:Glycated Hemoglobin; D007328:Insulin