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Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomesopen access

Authors
Kim, Hun-SungKim, HyunahYang, Hae-KyungLee, Eun YoungJeong, Yoo JinKim, Tong MinYang, So JungBaik, Seo YeonLee, Seung-HwanCho, Jae HyoungChoi, In YoungYim, Hyeon WooCha, Bong-Yun
Issue Date
Jun-2017
Publisher
KOREAN DIABETES ASSOC
Keywords
Blood glucose; Diabetes education; Diabetes mellitus; Health educators; Hemoglobin A; glycosylated
Citation
DIABETES & METABOLISM JOURNAL, v.41, no.3, pp 187 - 194
Pages
8
Journal Title
DIABETES & METABOLISM JOURNAL
Volume
41
Number
3
Start Page
187
End Page
194
URI
https://scholarworks.sookmyung.ac.kr/handle/2020.sw.sookmyung/2377
DOI
10.4093/dmj.2017.41.3.187
ISSN
2233-6079
2233-6087
Abstract
Background: When patients with diabetes mellitus (DM) are first referred to a hospital from primary health care clinics, physicians have to decide whether to administer an oral hypoglycemic agent (OHA) immediately or postpone a medication change in favor of diabetes education regarding diet or exercise. The aim of this study was to determine the effect of diabetes education alone (without alterations in diabetes medication) on blood glucose levels. Methods: The study was conducted between January 2009 and December 2013 and included patients with DM. The glycosylated hemoglobin (HbA1c) levels were evaluated at the first visit and after 3 months. During the first medical examination, a designated doctor also conducted a diabetes education session that mainly covered dietary management. Results: Patients were divided into those who received no diabetic medications (n=66) and those who received an OHA (n=124). Education resulted in a marked decrease in HbA1c levels in the OHA group among patients who had DM for <1 year (from 7.0%+/- 1.3% to 6.6%+/- 0.9%, P=0.0092) and for 1 to 5 years (from 7.5%+/- 1.8% to 6.9%+/- 1.1%, P=0.0091). Those with DM >10 years showed a slightly lower HbA1c target achievement rate of <6.5% (odds ratio, 0.089; P=0.0024). Conclusion: For patients who had DM for more than 5 years, higher doses or changes in medication were more effective than intensive active education. Therefore, individualized and customized education are needed for these patients. For patients with a shorter duration of DM, it may be more effective to provide initial intensive education for diabetes before prescribing medicines, such as OHAs.
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