title: Diabetes education program for people with type 2 diabetes: An international perspective.
abstract: In the Palestinian community, lifestyle changes, rapid urbanization and socioeconomic development, stress, smoking, and changes in food habits has increased the risk of non-communicable diseases especially diabetes mellitus. Diabetes complications can be prevented if the glycemic status of patients with diabetes is maintained within a nearly normal range. Therefore, patient education is critical in controlling blood glucose levels within the normal range.
  
  
  
  This study aimed at measuring the effect of diabetes educational intervention program for patients suffering from type 2 diabetes attending the Diabetes Clinic in Tulkarim Directorate of Health.
  
  
  
  A short duration observational study involving pre- and post-test educational intervention program was carried out on a relatively small number of type 2 diabetes patients at the Diabetes Clinic in Tulkarim Directorate of Health. In total, 215 patients attended a group-based 4h educational intervention session about diabetes. The program included explaining diabetes mellitus-symptoms, risk factors, types, treatment and complications and main aspects of self-care of the disease (foot care, eye care, and blood glucose monitoring), main aspects of dietary management, weight reduction, blood pressure, smoking cessation, periodic investigations, home monitoring and importance of physical activity. Knowledge evaluation questionnaire were evaluated pre- and post-study. Anthropometric measurements such as body weight (WT), body mass index (BMI) and laboratory tests such as fasting blood glucose (FBG), hemoglobin A1C (HbA1c), cholesterol (Chol), and triglycerides (TG) were measured both at the beginning and at the end of the study. Significance of the results was assessed by paired t-test at 95% confidence interval.
  
  
  
  The participant's mean age was 51.07 that ranged between 31 and 70 years. For a total of 215 participants, 41.4% were males and 58.6% were females. The mean weight before educational intervention was 80.81±14.95kg (82.6kg for males and 79.5kg for females) that decreased to 78.9±14.33kg (81.1kg for males and 77.3kg for females) after educational intervention program. The BMI also decreased significantly after educational intervention. The mean fasting blood sugar was 188.65±71.45mg/dL before educational intervention that decreased to 177.7±66.11mg/dL after the educational intervention (p=0.049). The mean glycosylated hemoglobin was 8.57±1.21 before educational intervention that decreased to 7.95±1.42 after educational intervention. The mean value of cholesterol before educational intervention was 183.27±37.74mg/dL that decreased to 169.57±34.23mg/dL after educational intervention. The mean triglycerides value decreased after educational intervention from 209.85±171.04mg/dL to 183.28±152.4mg/dL (p=0.025). The mean score of knowledge questionnaire before educational intervention was 60.6±20.65 that increased to 78.1±13.4 after conducting educational intervention.
  
  
  
  Diabetes education was found to be effective on BMI, FBG, HbA1c, Chol, TG, and knowledge.
  
  
  
  Diabetes education is a cornerstone in the management and care of diabetes and should be an integral part of health planning involving patient's family, diabetes care team, community, and decision makers in the education process.
authors.affiliation: Diabetes Clinic, Tulkarim Directorate of Health, Tulkarim, Palestine. Electronic address: palestinerashed@yahoo.com.
authors.forename: Osama A
authors.initials: OA
authors.lastname: Rashed
authors.affiliation: Public Health Nutrition Department, Zayed University, Dubai, United Arab Emirates. Electronic address: Haleemah.AlSabah@zu.ac.ae.
authors.forename: Haleama Al
authors.initials: HA
authors.lastname: Sabbah
authors.affiliation: Zirve University, Gazianteap, Turkey. Electronic address: younis99@gmail.com.
authors.forename: Mustafa Z
authors.initials: MZ
authors.lastname: Younis
authors.affiliation: Zirve University, Gazianteap, Turkey. Electronic address: adnan.kisa@zirve.edu.tr.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kisa
authors.affiliation: Biomedical Sciences and Natural Sciences, Keiser University, Fort Myers, FL, USA. Electronic address: jaiparkash@hotmail.com.
authors.forename: Jai
authors.initials: J
authors.lastname: Parkash
mesh_terms: D000328:Adult; D000368:Aged; D018912:Arabs; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D016730:Program Development; D015397:Program Evaluation
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Chronic diseases; Diabetes educational intervention; International health; Middle eastern countries; Type 2 diabetes