Intensive individualized reinforcement education is important for the prevention of hypoglycemia in patients with type 2 diabetes.
BACKGROUND
We investigated whether an intensive individualized reinforcement education program could influence the prevention of hypoglycemic events in patients with type 2 diabetes.


METHODS
From March 2013 to September 2013, patients aged 35 to 75 years with type 2 diabetes who had not previously participated in diabetes education, and treated with insulin or a sulfonylurea-containing regimen were included in the study. After structured group education, the patients assigned to the intensive individualized education group (IT) were requested to visit for reinforcement. All subjects in the IT were encouraged to self-manage dose adjustments. Participants in both groups (control group [CG, group education only; n=22] and IT [n=24]) attended follow-up visits at 2, 8, 12, and 24 weeks. At each visit, all patients were asked whether they had experienced hypoglycemia.


RESULTS
The total study population consisted of 20 men (43.5%; mean age and diabetic duration of 55.9±11.0 and 5.1±7.3 years, respectively). At 24 weeks, there were no significant differences in hemoglobin A1c values between the CG and IT. The total number of hypoglycemic events per patient was 5.26±6.5 in the CG and 2.58±2.3 times in the IT (P=0.004). Adherence to lifestyle modification including frequency of exercise, self-monitoring of blood glucose, or dietary habit was not significantly different between the groups. However, adherence to hypoglycemia management, especially the dose adjustment of medication, was significantly higher in the IT compared with the CG.


CONCLUSIONS
Compared with the structured group education, additional IT resulted in additional benefits in terms of avoidance of hypoglycemia and treating hypoglycemia in patients with type 2 diabetes.
Diabetes Care Team, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Yun-Mi
YM
Yong
Diabetes Care Team, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Kyung-Mi
KM
Shin
Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Kang-Min
KM
Lee
Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Jae-Young
JY
Cho
Diabetes Care Team, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea. ; Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Sun-Hye
SH
Ko
Diabetes Care Team, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Min-Hyang
MH
Yoon
Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Tae-Won
TW
Kim
Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Jong-Hyun
JH
Jeong
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Yong-Moon
YM
Park
Diabetes Care Team, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea. ; Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Seung-Hyun
SH
Ko
Diabetes Care Team, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea. ; Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Yu-Bae
YB
Ahn
Diabetes education; Diabetes mellitus, type 2; Hypoglycemia