Efficacy of structured education in patients with type 2 diabetes mellitus receiving insulin treatment

被引:34
|
作者
Guo, Xiao Hui [1 ]
Ji, Li Nong [2 ]
Lu, Ju Ming [3 ]
Liu, Jie [4 ]
Lou, Qing Qing [5 ]
Liu, Jing [6 ]
Shen, Li [1 ]
Zhang, Ming Xia [2 ]
Lv, Xiao Feng [3 ]
Gu, Ming Jun [7 ]
机构
[1] Peking Univ, Hosp 1, Beijing 100034, Peoples R China
[2] Peking Univ, Peoples Hosp, Beijing 100034, Peoples R China
[3] Chinese Peoples Liberat Army Gen Hosp Beijing, Beijing, Peoples R China
[4] Shanxi Prov Peoples Hosp, Taiyuan, Peoples R China
[5] Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Hangzhou 310003, Zhejiang, Peoples R China
[6] Gansu Prov Peoples Hosp, Lanzhou, Peoples R China
[7] Shanghai Pudong New Area Gongli Hosp, Shanghai, Peoples R China
关键词
diabetes mellitus type 2; glycemic control; insulin; medication compliance; structured education; CHINESE ADULT-POPULATION; SELF-MANAGEMENT; GLYCEMIC CONTROL; PREVALENCE; GLUCOSE;
D O I
10.1111/1753-0407.12100
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The aim of the present study was to assess the efficacy of structured education in insulin-treated type 2 diabetes mellitus (T2DM) patients. Methods: In a 16-week open-label randomized controlled study, 1511 T2DM patients with inadequate responses to two or more oral antidiabetic drugs (OADs) for > 3 months (HbA1c > 7.5%) were randomized (1:1) to either an education group (structured diabetes education plus insulin therapy) or a control group (usual care plus insulin therapy). Both groups discontinued previous OADs (except biguanides and alpha-glucosidase inhibitors) and started twice daily injections of 30% soluble-70% isophane recombinant insulin. The primary endpoint was the change in HbA1c from baseline. Efficacy and safety data were analyzed for within-and between-group differences. Results: Of the initial 1511 patients, 1289 completed the study (643 in the control group; 646 in the education group). At the end of the study, significant reductions in HbA1c versus baseline were evident in both groups, but the reduction was greater in the education group (2.16% vs 2.08%; P < 0.05). A higher proportion of patients in the education group achieved target HbA1c levels < 7% (43.81% vs 36.86%; P < 0.05) and <= 6.5% (28.48% vs 22.71%; P < 0.05). In addition, patients in the education group showed greater increments in scores and improvement in the Morisky Medication Adherence Scale (P < 0.05). The overall incidence of hypoglycemic events was similar in the two groups. Conclusions: Structured education can promote the ability of patients to self-manage and their compliance with medications, thereby achieving better outcomes.
引用
收藏
页码:290 / 297
页数:8
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