The effect of diabetes self-management education on psychological status and blood glucose in newly diagnosed patients with diabetes type 2

https://doi.org/10.1016/j.pec.2018.03.020Get rights and content

Highlights

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    Significance of Problem Based Learning in education of T2DM patients.

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    Improvement of psychological status of T2DM patients after self-management education.

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    Better control of blood glucose of T2DM patients after self-management education.

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    Psychological improvement of T2DM patients reinforcing the outcome of education.

Abstract

Objective

The purpose of this study was to evaluate the efficacy of self-management education on psychological outcomes and glycemic control in type 2 diabetes mellitus.

Methods

Patients were randomly assigned to education group and control group. Education group received professional education and control group received routine outpatient education.

Results

A total of 118 patients were randomly assigned to two groups (education group, n = 63; control group, n = 55). Compared with control group, the anxiety score (36.00 vs. 42.50, P < 0.05) and depression score (35.50 vs. 44.00, P < 0.05) significantly decreased at the sixth month in education group, respectively. Compared with control group, fasting blood glucose (6.78 mmol/L vs. 7.70 mmol/L, P < 0.00), postprandial blood glucose (7.90 mmol/L vs. 10.58 mmol/L, P < 0.00) and glycosylated haemoglobin A1C level [6.20 (5.80, 6.60)% vs. 6.70 (6.40, 7.30)%, P < 0.01] significantly decreased after the sixth month in education group.

Conclusion

The psychological status and blood glucose of patients with diabetes receiving self-management education were significantly improved. Practice Implications: Type 2 diabetes mellitus has been usually linked to increased prevalence and risk of depression and anxiety, which can affect blood glucose levels. Through education, the mood of newly diagnosed patients with diabetes improved, resulting in better blood glucose control.

Introduction

Type 2 diabetes mellitus (T2DM) is a worldwide epidemic, and its prevalence is growing, creating a global healthcare burden. It is linked to increased risk of severe cardiovascular complications, morbidity and mortality which can be reduced by optimal glycemic control [1]. According to the International Diabetes Federation, in 2015 it was estimated that there were 415 million people with diabetes aged 20–79 years, and this figure was predicted to rise to 642 million by 2040 [2]. To effectively manage individuals with diabetes, appropriate education, lifestyle modification, medication treatment and blood glucose monitoring are all required. Education is the foundation of care for all diabetes patients who want to achieve successful health related outcomes [3]. Diabetes self-management training, the process of teaching individuals to manage their diabetes, has been considered as an important part of clinical management since the 1930s. 50–80% individuals with diabetes lack of knowledge about diabetes education, and ideal glycosylated haemoglobin A1C (HbA1C) 7.0% target is achieved in less than half of type 2 diabetes [[4], [5],6]. Extensive self-management related to diet, exercise and medication are regarded as critical treatment for all patients with diabetes [7]. As such, diabetes self-management education (DSME) is widely recommended and carried out. However, despite the great variety of DSME programs that are currently available internationally, there is a lack of knowledge about the importance of diabetes education in the treatment of diabetes and in prevention of diabetes complications in developing countries [[8], [9]]. Also patients with diabetes have an increased risk of developing mental disorders and psychological disturbances. Previous studies suggested that compared to the general population, individuals with diabetes have a higher prevalence of depression and anxiety [[10], [11]]. Therefore, the primary objective of the present study was to evaluate the efficacy of self-management education on psychological outcomes and glycemic control in newly diagnosed T2DM.

Section snippets

Study design

The study was approved by the Ethics Committee in the First Hospital of Dandong. The patients involved in the study were recruited from both outpatients and inpatients of the First Hospital of Dandong. The physician in charge of this research first introduced the program to patients eligible. With patients’ consent, the Informed Consent Forms were signed hereafter. Based on the statistical analysis, there was about 5% patient eligible but failing to participate in this study. Patients had the

Baseline data

A total of 118 patients were assigned to the education group (n = 63) and control group (n = 55). No significant differences between groups were detected with respect to baseline clinical data and laboratory findings between the two groups. (Table 1)

Six months outcomes

In education group, anxiety score decreased from 40.00 (38.00, 47.00) at baseline to 36.00 (30.75, 40.50) at the sixth month (P < 0.05), and depression score decreased from 41.00 (38.00, 47.75) at baseline to 35.50 (30.75, 42.25) at the sixth month (

Discussion

Diabetes mellitus is a chronic and progressive disease and characterized by insulin resistance and relative insulin deficiency. Poorly controlled blood glucose leads to serious complications, which will impose a large economic burden on the individual and healthcare system. Hence, caring of patients with diabetes is of growing importance to public health. For proper control of diabetes mellitus, it is essential for patients to actively participate in their own management such as appropriate

Conflicts of interest

None.

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