title: Diabetes education of patients and their entourage: out-of-hospital national study (EDUCATED 2).
abstract: OBJECTIVE
  To determine the contributing factors in the successful diabetes education of patients and their entourage.
  
  
  METHODS
  Prospective observational study conducted in a pre-hospital setting by 17 emergency services across France (September 2009-January 2011) included all insulin-treated patients (≥18 years) provided that at least one family member was present on scene. Data were collected from patients and their entourage: (1) personal details including language proficiency and educational attainment, (2) treatments, (3) diabetes-related data (log sheets, glucose meter, glucagon, glycated hemoglobin, prior hypoglycemic episodes); (4) care by diabetologist, general practitioner and/or visiting nurse. The main end points were ability to measure capillary blood sugar (patient) and awareness of hypoglycemia symptoms and ability to administer glucagon (entourage).
  
  
  RESULTS
  Overall, 561 patients and 736 family members were included; 343 patients (61%) were experiencing a hypoglycemic episode (<2.5 mmol/L). A total of 141 (75%) patients and 343 (50%) family members could measure capillary blood sugar. They could name a median of 2 [0-3‰] hypoglycemia symptoms although 217 (39%) patients and 262 (39%) family members could name no symptom. Few patients (33%) had glucagon available. In multivariate analyses, the main factor associated with better patient education was care by a diabetologist. Lack of an educational qualification and visits by a nurse were associated with poor patient education, and French mother tongue and care by a diabetologist with better education of the entourage.
  
  
  CONCLUSIONS
  In France, diabetic patients and their entourage are inadequately educated. Their education benefits most from care by a diabetologist.
authors.affiliation: AP-HP, Urgences - SAMU 93, Unité Recherche-Enseignement-Qualité, Hôpital Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France. frederic.lapostolle@aphp.fr.|Université Paris 13, Sorbonne Paris Cité, EA 3509, 93000, Bobigny, France. frederic.lapostolle@aphp.fr.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lapostolle
authors.affiliation: AP-HP, Urgences - SAMU 93, Unité Recherche-Enseignement-Qualité, Hôpital Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France.|Université Paris 13, Sorbonne Paris Cité, EA 3509, 93000, Bobigny, France.
authors.forename: Nadia
authors.initials: N
authors.lastname: Hamdi
authors.affiliation: SAMU 94, Hôpital Henri Mondor, 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil, France.
authors.forename: Majed
authors.initials: M
authors.lastname: Barghout
authors.affiliation: SAMU 36, C.H. de Chateauroux, 216 avenue de Verdun, 36000, Chateauroux, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Soulat
authors.affiliation: SAMU 74, C.H. de la région d'Annecy, 1 avenue de l'hôpital - Metz-Tessy, BP 90074, 74374, Pringy, France.
authors.forename: Anna
authors.initials: A
authors.lastname: Faucher
authors.affiliation: SAMU 78, C.H. André Mignot, 177 rue de Versailles, 78150, Le Chesnay, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Lambert
authors.affiliation: SAMU 76, G.H. du Havre, BP 24, 76083, Le Havre, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Peschanski
authors.affiliation: SMUR de l'hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110, Clichy, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Ricard-Hibon
authors.affiliation: SAMU 69, C.H. Edouard Herriot, 5 place d'Arsonval, 69437, Lyon Cedex 3, France.
authors.forename: Carine
authors.initials: C
authors.lastname: Chassery
authors.affiliation: SAMU 83, C.H. de Toulon, 1208 avenue Colonel Picot, BP 1412, 83056, Toulon, France.
authors.forename: Maryline
authors.initials: M
authors.lastname: Roti
authors.affiliation: SAMU 31, C.H. de Purpan, Place du Dr Baylac, 31059, Toulouse Cedex 9, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Bounes
authors.affiliation: SAMU 38, C.H.U. de Grenoble, BP 217, 38043, Grenoble Cedex 9, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Debaty
authors.affiliation: SAMU 64, C.H. de la Côte Basque, Avenue Loeb, 64109, Bayonne, France.
authors.forename: Tarak
authors.initials: T
authors.lastname: Mokni
authors.affiliation: SAMU Guyane, C.H. de Cayenne, Rue des flamboyants, BP 6006, 97306, Cayenne, France.
authors.forename: Gérald
authors.initials: G
authors.lastname: Egmann
authors.affiliation: SAMU 47, C.H. d'Agen, 8 rue Marcel Pagnol, 47510, Foulayronnes, France.
authors.forename: Pierre-Arnaud
authors.initials: PA
authors.lastname: Fort
authors.affiliation: SAMU 21, C.H.U. de Dijon, 3 rue du Faubourg Raines, 21033, Dijon, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Boudenia
authors.affiliation: SMUR Orsay, C.H. d'Orsay, Place du Général Leclerc, BP 27, 91401, Orsay, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Alayrac
authors.affiliation: SAMU 56, C.H. de Vannes, 20 boulevard du Général Guillaudot, 56017, Vannes, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Safraou
authors.affiliation: AP-HP, Urgences - SAMU 93, Unité Recherche-Enseignement-Qualité, Hôpital Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France.|Université Paris 13, Sorbonne Paris Cité, EA 3509, 93000, Bobigny, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Galinski
authors.affiliation: AP-HP, Urgences - SAMU 93, Unité Recherche-Enseignement-Qualité, Hôpital Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France.|Université Paris 13, Sorbonne Paris Cité, EA 3509, 93000, Bobigny, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Adnet
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D005934:Glucagon / Q000097:blood; D006442:Glycated Hemoglobin / Q000378:metabolism; D006266:Health Education / Q000592:standards / Q000706:statistics & numerical data; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012944:Social Support
chemical_list: D001786:Blood Glucose; D005934:Glucagon; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Diabetes; Education; Family; Hypoglycemia