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The Diabetes Educator
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FEATURES

A Structured Educational Program Improves Metabolic Control in Patients With Type 2 Diabetes

A Randomized Controlled Trial

Suzana Fiore Scain, RN, PhD, Rogério Friedman, MD, PhD and Jorge Luiz Gross, MD, PhD

From the Public Health Unit (Dr Scain) and Endocrine Division (Dr Friedman, Dr Gross), Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.

Correspondence to Rogério Friedman, MD, PhD, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Prédio 12–4° andar, 900035-903 Porto Alegre, RS, Brazil (rfriedman{at}hcpa.ufrgs.br).

Purpose

To evaluate the effectiveness of a structured education group program in metabolic control in patients with type 2 diabetes.

Methods

A randomized controlled trial was conducted in a public teaching hospital and tertiary care center. Participants were 104 patients with type 2 diabetes not using insulin (aged 59 ± 9.5 years, diabetes duration of 10.5 ± 6.70 years, 53% women) randomized to attend an 8-hour structured group education program (delivered in 4 sessions, for 4 weeks, by a trained nurse educator) or to usual care. A pretest and posttest assessed the patients' knowledge before and after the course. The main outcome measures were A1C, weight, blood pressure, and lipids at 4-month intervals, up to 12 months.

Results

A1C levels decreased significantly in the intervention group after the 4th month and remained lower than in the control group until the 12th month (multivariate analysis of covariance, with baseline A1C as a covariate). Weight, blood pressure levels, total cholesterol, and high-density lipoprotein levels improved significantly, and similarly, in both groups.

Conclusions

A structured education group program centered in self-management improves the glycemic control in patients with type 2 diabetes, reaching the peak effect at 4 months, and lasting for up to 12 months.

This version was published on July 1, 2009

The Diabetes Educator, Vol. 35, No. 4, 603-611 (2009)
DOI: 10.1177/0145721709336299
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