Enhancing gestational diabetes management in Filipino patients: Evaluating the impact of education on knowledge, attitude, and pregnancy outcomes at a Tertiary Medical Center

Introduction@#Patient education is integral in the management of gestational diabetes mellitus (GDM), a common pregnancy complication that may cause adverse perinatal outcomes. This study evaluated the effect of diabetes education on the knowledge and attitude among patients with GDM, comparing pre- vs post-diabetes session scores and determining pregnancy outcomes.@*Methodology@#A one-group pre-test and post-test experimental design study was conducted on 75 patients after one- session diabetes counseling using the Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) and the third version of the Diabetes Attitude Scale (DAS-3).@*Results@#Of the 75 subjects, 84% exhibited adequate knowledge of diabetes. Post-education, a significant increase in the total scores was seen among those less than 35 years of age (p-value: 0.003), both employed and unemployed (p-value: 0.0.026, 0.047, respectively), with a secondary level of education (p-value: 0.014) and multigravid (p-value: 0.015). An overall median positive attitude score of 3.6 was documented. For neonatal outcomes, no adverse events existed. For maternal outcomes, 17.9% had elevated fasting blood glucose while 7.1% had elevated 2-hour post-glucose tolerance test.@*Conclusion@#Diabetes education improves patient’s knowledge but not their attitude. Hence, improvement in attitude interventions should be incorporated into the current diabetes education program.

Family-integrated diabetes education for individuals with diabetes in South-west Nigeria

Objectives: This study aimed to determine the effects of family-integrated diabetes education on diabetes knowthe ledge of patients and family members, as well as its impact on patients' glycosylated haemoglobin (A1C). Design: The design was a two-group Pretest Posttest quasi-experimental. Setting: The study took place at the diabetes clinics of two tertiary hospitals in southwestern Nigeria. Participants: People Living with Diabetes (PLWD) and family members aged 18 years and over and without cognitive impairment were placed, as clusters, into either a control group (CG) or an intervention group (IG) The CG comprised 88 patients and 88 family members while IG comprised 82 patients and 82 family members. Of these, 78 and 74 patients completed the study in CG and IG, respectively. Interventions: PLWD in IG along with their family members were given an educational intervention on diabetes management and collaborative support with an information booklet provided. This was followed by three (3) complimentary Short Messaging Service (SMS). Main outcome measures: A1C and diabetes knowledge. Results: Over half (52.4%) and about a fifth (18.2%) of family members and patients, respectively, had never had diabetes education. There was a statistically significant increase in the knowledge of patients and family members in IG. Unlike CG, the A1C of patients in IG improved significantly at three and six-month post-intervention, (p<0.01). Regression showed an independent effect of family members' knowledge on IG's A1C. Conclusions: Improved family members' diabetes knowledge positively impacted patients' glucose level. There is a need to integrate family members into diabetes care better

Family-integrated diabetes education for individuals with diabetes in South-west Niger

Objectives: This study aimed to determine the effects of family-integrated diabetes education on diabetes knowthe ledge of patients and family members, as well as its impact on patients' glycosylated haemoglobin (A1C). Design: The design was a two-group Pretest Posttest quasi-experimental. Setting: The study took place at the diabetes clinics of two tertiary hospitals in southwestern Nigeria. Participants: People Living with Diabetes (PLWD) and family members aged 18 years and over and without cognitive impairment were placed, as clusters, into either a control group (CG) or an intervention group (IG) The CG comprised 88 patients and 88 family members while IG comprised 82 patients and 82 family members. Of these, 78 and 74 patients completed the study in CG and IG, respectively. Interventions: PLWD in IG along with their family members were given an educational intervention on diabetes management and collaborative support with an information booklet provided. This was followed by three (3) complimentary Short Messaging Service (SMS).Main outcome measures: A1C and diabetes knowledge. Results: Over half (52.4%) and about a fifth (18.2%) of family members and patients, respectively, had never had diabetes education. There was a statistically significant increase in the knowledge of patients and family members in IG. Unlike CG, the A1C of patients in IG improved significantly at three and six-month post-intervention, (p<0.01). Regression showed an independent effect of family members' knowledge on IG's A1C. Conclusions: Improved family members' diabetes knowledge positively impacted patients' glucose level. There is a need to integrate family members into diabetes care better.

Ambulatory glucose profile as an educational tool in the management of patients with type 2 diabetes mellitus

A 60-year-old male patient with Type 2 Diabetes Mellitus (T2DM) since the last two years was presented in the clinic with repeated falls. He was on dietary treatment and was also taking metformin 500 mg twice daily, on and off. His Fasting Plasma Glucose (FPG) was 116 mg/dL, Postprandial Glucose (PPG) was 140 mg/dL and Glycosylated Haemoglobin (HbA1c) was 6.4%. The complete glycaemic profile obtained from the first Ambulatory Glucose Profile (AGP) revealed that the patient was not having hypoglycaemia and has very minimal glucose fluctuations without any post-prandial excursions. The visual cue obtained from Continuous Glucose Monitoring (CGM) / AGP enabled physicians to better inform the patient on the effects of medication and lifestyle on diabetes, thereby allowing the patient to make informed treatment and lifestyle modifications. This case study sheds light on the need to recommend AGP in such cases to provide insights on the glucose trends, thereby improve patient’s confidence in the therapy, with lifestyle modification.

The development and acceptability of a board game to supplement standard diabetes education at the University of Santo Tomas Hospital

Introduction@#The potential efficacy of a board game in health education has been demonstrated. This study aims to develop a simple and useful diabetes education board game for adult Filipinos with T2DM that can supplement diabetes education.@*Methods@#This study used a mixed methods design involving a multistep process to develop and evaluate the board game. The initial phase involved the generation of comprehensible illustrations. Diabetes experts including three endocrinologists, one diabetes education nurse, and one dietician and 20 patients evaluated each illustration incorporated into the game board patterned after snakes and ladders. Twenty adult patients were then recruited to play the board game. Each patient subsequently completed a survey regarding perception of the game’s acceptability in terms of usability, replay appeal, and ability to reinforce knowledge.@*Results@#The illustrations’ comprehensibility or mean correct response of participants to the illustrations was 75%. At least 50% of patients correctly identified each of the illustrations. Eighteen (56.25%) out of the 32 illustrations had a mean correct response of 75% or higher. The illustrations were perceived to depict their intended meaning (translucency). All illustrations had a median translucency score of five and above in a scale of one to seven. The game had a high median rating for acceptability of five on a scale of one to five. All the participants agreed that they liked playing the game and would recommend the game to other patients with diabetes.@*Conclusion@#The developed adult diabetes board game – “Winning at Diabetes”, is a simple, useful and acceptable supplement to standard diabetes education.

Educación nutricional en diabetes: una estrategia emergente en venezuela / Nutritional Diabetes Education: an emerging strategy in Venezuela

La Educación Terapéutica en Diabetes constituye una parte fundamental para el control adecuado de la diabetes, y dentro de esta la educación nutricional en Diabetes es fundamental, ya que permite el empoderamiento de los pacientes con herramientas nutricionales que le permitan de forma sencilla y agradable realizar cambios en el estilo de vida para controlar los niveles de glicemia y alcanzar los objetivos metabólicos. En Venezuela aún no se reconoce en las instituciones universitarias ni de salud a la Educación en Diabetes como una carrera profesional, pero varios grupos trabajan en conjunto para promover las herramientas y competencias educativas, en especial las relativas a la alimentación y nutrición. En este trabajo se presenta una perspectiva de los hallazgos más relevantes que sientan los principios nutricionales y educativos de la estrategia de Educación Nutricional en Diabetes en Venezuela, con el fin de que se pueda aplicar cada día más en el país a través de los educadores en diabetes, nutricionistas-dietistas y el resto de los profesionales de la salud(AU)

Therapeutic Education in Diabetes is a fundamental part for the adequate management of diabetes, and diabetes nutritional education is also fundamental, this allows the empowerment of patients with nutritional tools that allow them in a simple and pleasant way to make changes in lifestyle to control blood glucose levels and achieve metabolic goals. In Venezuela, Diabetes Education is still not recognized in the university or health institutions as a professional career, but several groups work together to promote educational tools and competencies, especially those related to food and nutrition. This paper presents a perspective of the most relevant findings that establish the nutritional and educational principles of the strategy of nutrition education in diabetes in Venezuela, so that it can be applied every day more in the country through educators in diabetes, Nutritionists-Dietitians and the rest of health professional(AU)

Efectividad de una estrategia educativa dirigida a adultos mayores diabéticos tipo 2 y proveedores de salud / Effectiveness of an educational strategy aimed at older adults suffering from type 2 diabetes and at health providers

Objetivo: Evaluar la efectividad de la estrategia educativa dirigida a adultos mayores diabéticos tipo 2 y proveedores de salud. Métodos: Investigación cuasi experimental que evaluó un antes-después con grupo control. El universo de estudio estuvo constituido por adultos mayores diabéticos dispensarizados en los policlínicos Hermanos Cruz (U= 1 369) y Pedro Borrás (U= 1 528), del primero se seleccionó el grupo experimental y en el segundo el grupo control, ambos del municipio y provincia Pinar del Río. Para determinar la muestra se utilizó un Muestreo por Conglomerados Bietápico con probabilidades proporcionales al tamaño de las Unidades de Primera Etapa quedando conformada para ambos grupos por 123 adultos mayores diabéticos tipo 2. Se trabajó con el universo de prestadores del GBT uno (U= 84) del policlínico Hermanos Cruz. La estrategia fue aplicada en el grupo experimental, y evaluada de forma inmediata, a los seis meses y al año. Resultados: Las comparaciones de los grupos en los momentos relacionados con la aplicación de la estrategia estuvieron dentro de lo esperado, generalmente se produjeron cambios significativos en los adultos mayores diabéticos tipo 2 en cuanto a los resultados globales y en cada una de las preguntas examinadas a favor del grupo experimental e igualmente en los proveedores de salud. Conclusiones: La mejoría detectada en los resultados de las variables de respuesta principal y secundarias, en el grupo experimental, dan una medida de la efectividad de la estrategia. Al mismo tiempo su estabilidad a los seis meses y al año considerado como horizonte temporal de evaluación, avalan su sostenibilidad(AU)

Objective: To evaluate the effectiveness of the educational strategy aimed at type 2 diabetic older adults and at health providers. Method: A quasi experimental research study to evaluate the situation before and after the application of this strategy in a control group. The study population consisted of diabetic old patients recruited at Hermanos Cruz (U= 1 369) and Pedro Borrás Astorga (U= 1 528) polyclinics. The experimental group was chosen from the first group and the control group from the second one, both in Pinar del Río municipality in Pinar del Rio province. A two-staged cluster was used with proportional probabilities according to the size of the first stage units and the final sample was 123 type 2 diabetic older adults for both groups. All the basic working team health providers from Hermanos Cruz polyclinics were involved in the study. The strategy was applied in the experimental group and immediately evaluated after six months and after a year. Results: The comparisons of the groups made at the time of the implementation of the strategy were within the expectations; there were significant changes in type 2 diabetics in terms of overall outcomes and each of the analyzed questions, which favored the experimental group along with the health providers. Conclusions: The improvement observed in the results of the answer variables of the experimental group shows the strategy effectiveness. At the same time, the stability of results after six months and a year endorses the strategy sustainability(AU))

Training and thinking of diabetes education in the United States / 中国糖尿病杂志

Based on my training experience in the United States,here introduced the situation of diabetes education and management in the United States,diabetes educator certification and the education program of outpatients and inpatients. This information can provide advice to improve the current status of diabetes education in China.

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

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 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.

The effect of a single-session diabetes education on the knowledge, and attitudes of patients with type 2 Diabetes Mellitus seen at out-patient clinics in Chinese General Hospital: A prospective cohort study

Introduction@#With the increasing prevalence of diabetes mellitus (DM) in the Philippines, Diabetes Self-Management Education (DSME) remains to play a vital role in diabetes care. It is important in optimizing metabolic control, preventing and managing complications, and maximizing quality of life in a cost-effective manner. This study aimed to determine the effect of diabetes education on the knowledge and attitudes of type 2 DM patients. It also aimed to determine the topics that needed more emphasis during education. @*Methods@#A prospective study, which included 75 patients: 38 patients in the education group and 37 patients in the noneducation group, was conducted. A single session diabetes education was given to the patients in the education group. Baseline and follow-up knowledge and attitude scores by using the modified, validated, Filipino versions of American Association of Clinical Endocrinologists (AACE) Knowledge Evaluation Form and Diabetes Attitude Scale–3 (DAS–3), respectively, were compared between the education and non-education groups. The changes in weight and body mass index (BMI) for both groups were also compared.@*Results@#Results showed that on follow-up, there was a significant increase in the mean percentage scores for knowledge in the education group. There was no significant increase in mean frequency of correct answers for questions on precautions prior to exercise, monitoring, nutrition and medication adjustment during ill days. Questions on psychosocial impact, and value of tight glucose control showed significant improvement in the education group, while one question on seriousness of diabetes did not improve significantly.@*Conclusion@#Diabetes education generally improved the knowledge and attitudes of patients towards their disease.

Intervención educativa con participación comunitaria dirigida a adultos mayores diabéticos tipo 2 / Educational intervention with community participation aimed at type 2 diabetic old-age people

Introducción: una de las formas más factibles para identificar problemas, y buscar soluciones es la investigación-acción-participativa como dimensión de la Educación Popular. Objetivo: promover la participación comunitaria en la dilucidación de problemas, en la toma de decisiones y en las medidas iniciadas para transformar los factores de riesgo y pronósticos de complicaciones crónicas de la diabetes mellitus tipo 2 en el adulto mayor. Métodos: la investigación clasifica como desarrollo tecnológico, al brindar la metodología utilizada en la intervención educativa comunitaria. El estudio se realizó en el policlínico Hermanos Cruz de Pinar del Río en el período de 2011-2014. Como universo se consideró la totalidad de población adulta mayor con diabetes mellitus tipo 2 (U= 1369), del policlínico para el año 2012. La muestra por conglomerados bietápico quedó conformada por 123 pacientes. En la primera etapa se hizo un estudio descriptivo. A partir de estos resultados, se desarrolló la metodología educativa, donde se plantearon diferentes acciones reflejadas en el plan de acciones comunitarias Renacer a la Vida. Resultados: se verificó la responsabilidad de la comunidad junto al médico y la enfermera de la familia, para que las personas adultas mayores con diabetes modifiquen sus opiniones, hábitos y conocimientos. Igualmente se confirmó que en la comunidad se pueden hacer muchas acciones con las organizaciones políticas y de masas, además de actividades deportivas y culturales para trabajar la importancia de la educación al diabético. Conclusiones: el nivel primario de atención es excelente para establecer programas educativos con participación comunitaria dirigidos a adultos mayores diabéticos tipo 2(AU)

Introduction: One of the most feasible ways to identify problems and find solutions is through the participative-action research as a dimension of what is known as Popular Education. Objective: To promote community participation in the elucidation of problems, decision-making and the steps taken to transform risk factors and the prognosis of chronic complications of type 2 diabetes mellitus in the elderly. Methods: This research classifies as technological development by providing the methodology used in the community educational intervention. The study was conducted at Hermanos Cruz polyclinic of Pinar del Río during 2011-2014. The target group comprised the entire elderly population with type-2 diabetes mellitus (U= 1369) during 2012. The two-stage cluster sample was composed of 123 patients. A descriptive study was carried out in the first stage. From these results, an educational methodology was established, reflecting the different actions developed in the community; which is known as Renacer a la Vida. Results: Community's responsibility was verified by the doctor and family nurse, for old-people suffering from diabetes modify their view points, habits and knowledge. It was also confirmed that several activities can be planned in the community supported on the political and mass organizations; such as sport and cultural activities emphasizing the importance of education for diabetic population. Conclusions: Primary health care is an excellent context to establish educational programs involving the community, with the aim of educating type-2 diabetic old-age people(AU)

Educación terapéutica en diabetes en pacientes con una primera amputación por pie diabético / Therapeutic education on diabetes for patients with first amputation caused by diabetic foot

Introducción: la educación diabetológica es la base del tratamiento para las personas con diabetes, la falta de conocimientos sobre la enfermedad favorece la aparición de complicaciones. Objetivos: identificar las principales causas que provocaron una primera amputación por pie diabético, describir el seguimiento ambulatorio de estos pacientes y explorar los conocimientos sobre su autocuidado. Métodos: estudio descriptivo, de corte transversal en 110 pacientes diabéticos hospitalizados en el Instituto Nacional de Angiología por pie diabético sometidos a una primera amputación. Se analizaron variables demográficas y de salud, así como las características del seguimiento ambulatorio, los conocimientos de los pacientes sobre la enfermedad y las principales causas de la lesión desencadenante. Resultados: la edad promedio fue de 61 años; y 15,4 años de evolución de la enfermedad. El 70,8 por ciento de los pacientes no tenían un seguimiento ambulatorio periódico, menos del 32 por ciento recibió cursos de educación diabetológica. Solo un tercio acudía periódicamente a los servicios de podología. Muy pocos pacientes pudieron expresar de forma precisa y concreta los cuidados de los pies. Entre las principales causas comentadas por los pacientes, que desencadenaron la lesión y que terminó en una primera amputación estuvieron "los pinchazos" y "el rebajar callosidades". Conclusiones: la mayoría de los diabéticos con una primera amputación no tenían un seguimiento periódico ni especializado para su enfermedad, insuficientes conocimientos sobre su autocuidado lo que probablemente generó que las conductas inapropiadas identificadas causaran una lesión complicada que requirió una amputación. Se impone la necesidad de un proceso educativo que sea eficiente para todas las personas con diabetes y así reducir las amputaciones(AU)

Introduction: diabetes education is the mainstay of treatment for people with diabetes since lack of knowledge about the disease favors the occurrence of complications. Objectives: to identify the main causes that led to a first diabetic foot amputation, to describe outpatient monitoring of these patients and to explore their knowledge about self diabetic foot care. Methods: descriptive and cross-sectional study conducted in 110 diabetic patients hospitalized at the National Institute of Angiology due to first diabetic foot amputation. The demographic and health variables as well as the characteristics of patient follow-up, patients' knowledge about the disease and the leading cause of the triggering injury were all taken into consideration. Results: it was found that the average age was 61 years, and 15.4 years of disease progression. In the study group, 70.8 percent of patients had no regular outpatient follow-up, less than 32 percent had received education courses on diabetes. Only one third of them came regularly to podiatric services. Very few patients were able to clearly say the aspects of foot care. The main causes stated by patients, which triggered the injury and led to a first amputation, were "punctures" and "reducing calluses". Conclusions: most diabetics with a first amputation did not have a either systematic or specialized monitoring for disease, with insufficient knowledge about self diabetic foot care, which probably led to identified inappropriate behaviors that caused complications and finally amputation. It is necessary to implement an effective educational process for all the diabetic persons and thus reduce amputations(AU)

Capacity-building of the allied health workforce to prevent and control diabetes: lessons learnt from the National Initiative to Reinforce and Organize General Diabetes Care in Sri Lanka (NIROGI Lanka) project.

In 2008, to tackle the exponential rise in the clinical burden of diabetes that was challenging the health systems in Sri Lanka, a shift in focus towards patientcentred care linked with community health promotion was initiated by the National Initiative to Reinforce and Organize General Diabetes Care in Sri Lanka (NIROGI Lanka) project of the Sri Lanka Medical Association. Specific training of “diabetes educator nursing officers” (DENOs), field staff in maternal and child health, footwear technicians, and health promoters from the community, was instituted to improve knowledge, skills and attitudes in the area of control and prevention of diabetes. This article highlights some of the activities carried out to date with the allied health workforce and volunteer community. Specifically, it describes experiences with the DENO programme: the educational and administrative processes adopted, challenges faced and lessons learnt. It also highlights an approach to prevention and management of complications of chronic diabetic foot through training a cohort of prosthetics and orthotics technicians, in the absence of podiatrists, and an initiative to provide low-cost protective footwear. Harnessing the enthusiasm of volunteers – adults and schoolchildren – to address behavioural risk factors in a culturally appropriate fashion has also been a key part of the NIROGI Lanka strategy.

The Current Strategic Direction of Diabetes Education: American Association of Diabetes Educators Yearly Strategic Plan 2016~2018 / 임상당뇨병

The burden of diabetes mellitus (DM) has increased rapidly, affecting both individuals and society. Recent data suggest that multiple DM conditions impose an even larger burden on society and individuals. The effective self-management and prevention of DM has been one of the major agendas of health policy around the world. This is a time of sweeping change in health care regarding DM. To prepare for these changes, the American Association of Diabetes Educators (AADE) completed a thorough assessment of the current environment and trends affecting people with diabetes and diabetes education professionals. This paper explains the AADE 2016~2018 Strategic Plan, including ideas for empowering diabetes educators to expand the horizon of innovative education, management, and support. The roles and competencies of educators are evolving as various education delivery models advance and diversify.

Evaluación del programa de educación en diabetes en el adulto mayor / Assessment of Diabetes Education Program in the Elderly at Hermanos Cruz Polyclinic

Introducción: la Educación para la Salud es esencial en el abordaje terapéutico del diabético. No podemos introducir la dieta, el ejercicio y la medicación sin informar al paciente sobre su importancia y sin motivarlo para que adquiera protagonismo en el control de su enfermedad. Objetivo: evaluar tácticamente el programa de educación en diabetes a nivel del Consultorio Médico de la Familia. Métodos: estudio en el campo de la investigación en sistemas y servicios de salud, en el policlínico "Hermanos Cruz" durante el año 2012. Se utilizaron los criterios evaluativos elaborados en una investigación anterior por los autores según datos de estructura, proceso y resultado; así como indicadores y estándares. Resultados: la evaluación táctica de los componentes de estructura, proceso y resultados, resultó evaluada de no satisfactoria. Con el diseño y la aplicación de la evaluación se demostró que existen dificultades en el cumplimiento del programa de educación en diabetes en el área de salud estudiada, el nivel de satisfacción de los servicios en usuarios internos y externos es desfavorable. Conclusiones: las discrepancias detectadas entre el cumplimiento del programa de educación en diabetes y los estándares sirvieron de base para una estrategia encaminada a su perfeccionamiento(AU)

Introduction: Health Education is essential in diabetic therapeutic approach. We cannot introduce diet; exercising and medication without informing the patient of its importance, without motivatingpatient in controlling their disease. Objective: Tactically assess the diabetes education program at family doctor practice. Methods: A study in the field of research in health systems and services was conducted at HermanosCruzpolyclinic in 2012. Evaluative criteria were used by the authors. These criteria weredeveloped in previous research according to data structure, process and outcome; as well as indicators and standards. Results: The tactical evaluation of structure, process and results components proved unsatisfactory evaluated. There are difficulties in implementing the program of diabetes education in the health area studied showed by the design and implementation of this evaluation, the level of satisfaction of services in internal and external users is unfavorable. Conclusions: The discrepancies detected between program implementation and diabetes education standards were the basis for a strategy for its further development(AU)

Guía para evaluar el programa de educación en diabetes en la Atención Primaria de Salud / Guide to evaluating diabetes education Program in Primary Health Care

Introducción: la evaluación permanente de las acciones y resultados de los sistemas de salud es una de las principales expresiones de la rectoría del Estado y una de las mejores formas para alcanzar sus objetivos estratégicos. Objetivo: brindar una herramienta para la evaluación del programa de educación en diabetes a nivel de la Atención Primaria de Salud. Métodos: se realizó una investigación de desarrollo, que permitió la creación de una guía para expresar juicios de valor a partir de la comparación de los resultados alcanzados con estándares establecidos. Se estudiaron la disponibilidad del programa a nivel del consultorio y materiales para la educación en diabetes. Para el proceso, se diseñaron guías de observación y entrevistas con el fin de evaluar las principales actividades realizadas por el equipo de salud. Para operacionalizar criterios, indicadores y estándares se contó con la colaboración de varios expertos. Resultados: la guía propuesta constó de 32 criterios e indicadores para evaluar las diferentes dimensiones. En estructura se tuvieron en cuenta los médicos, enfermeras, licenciados en Cultura Física, psicólogos, podólogos y nutricionistas disponibles para ejecutar el programa y la capacitación de estos. Para este resultado se valoró la opinión de trabajadores y pacientes por los servicios recibidos y algunos indicadores como mortalidad, complicaciones, control glucémico adecuado, deseable o aceptable, cumplimiento del tratamiento e incorporación a los círculos de diabéticos. Conclusiones: esta guía contribuirá a evaluar la ejecución del programa de educación en diabetes en la Atención Primaria de Salud y, por tanto, a identificar las brechas entre lo deseado y lo observado, así como a orientar adecuadamente la distribución de los recursos humanos y materiales.

Introduction: ongoing evaluation of actions and outcomes of health systems is one of the main expressions of a state guidance and one of the best ways to achieve strategic objectives. Objective: provide a tool for assessing diabetes education program at Primary Health Care. Methods: a development research was conducted. It allowed the creation of a guide to express value judgments based on comparing the results obtained with established standards. Program availability at the office, and materials for education in diabetes were studied. Program availability at the medical practice office, and materials for education in diabetes were studied. For the process, observation and interview guides were designed to evaluate the main activities of the health team; in order to operationalize criteria, indicators and standards with the collaboration of several experts. Results: the proposed guide consisted of 32 criteria and indicators to assess different dimensions. In structure, available doctors, nurses, Physical Culture graduates, psychologists, podiatrists, and nutritionists were taken into account to run the program and training them. For this result, workers and patient's opinion on the services was assessed, as well as some indicators such as mortality, complications, appropriate, desirable or acceptable glycemic control, treatment compliance and incorporation into diabetics support groups. Conclusions: this guide will help assessing the implementation of diabetes education program in primary health care and, therefore, to identify gaps between what is desired and observed, as well as to properly guide the distribution of human and material resources.

"Diabetes Education Class IPE" -Challenge to promote new IPE (interprofessional education) with real patients- / 医学教育

<p>　The WHO reported the importance of IPE (Interprofessional Education) in order to implement team-based medicine smoothly. Some Japanese medical educational institutes presented their IPE programs, which involved real patients, but most IPE programs used scenario-based or standardized patients. Moreover, few reports showed IPE programs for diabetic patient education. We created a new program, called the "Diabetes education class IPE" . Participants were 2 medical, 4 nursing, 4 pharmacy, and 3 dietician students. The students experienced the planning and management of and reflection on diabetes education classes. As a result of reflection, the "Diabetes education class IPE" was viewed as a useful IPE program.</p>

Effects of diabetic health education pictures on blood sugar control and self-care ability of type 2 diabetic patients / 现代临床护理

Objective To investigate the effect of diabetic health education pictures on blood sugar control and self-care ability of type 2 diabetic patients. Methods Using the registration number and random digit table, 84 patients with type 2 diabetes mellitus were divided into the experiment group and the control group with 42 cases in each group. The control group received traditional diabetes knowledge education, and the experiment group was educated with the mode ofpicture and dialoguehealth education, 60 to 90min per week for 8 weeks. The patients in the two groups were observed before and after the intervention in terms of the fasting blood glucose, postprandial 2h blood glucose, glycatedhemoglobin (gycated, hemoglobin, HbAlc) and self-care ability. Result The differences in blood sugar value index and self-care behavior score after the intervention between the two groups were statistically significant (P<0.05). Conclusion Application of′picture and dialogue′education mode can enhance patients′ability of self-care behaviors the effect of health education and stabilize the level of blood glucose of patients.

Economic Evaluation of Diabetes Education / 임상당뇨병

BACKGROUND: Diabetes education, also known as diabetes self-management training or diabetes selfmanagement education, is effective in helping patients with diabetes control their illness and maximize their health. However, there is no established institutional strategy in South Korea because economic evaluations of the benefits and costs of diabetes education have been limited. The purpose of this study is two-fold: (1) describe economic evaluation methodologies, one of the tools available to help choose wisely from a range of alternatives and implement effective resources; and (2) suggest applications of economic evaluation in terms of diabetes education. METHODS: There are three types of commonly used economic evaluations in diabetes education: cost benefit analysis, cost effective analysis, and cost utility analysis. RESULTS: The understanding of the economic value of diabetes education for people with diabetes has a number of uses: to provide empirical evidence to influence policy-making in diabetes education, to offer proof of the benefits of diabetes self-management, to improve awareness of the importance and necessity of diabetes education, to reduce costs of diabetes management, and to enhance healthcare quality. CONCLUSION: Further research is needed to evaluate the economic benefits and costs associated with diabetes education.

Intensive Individualized Reinforcement Education Is Important for the Prevention of Hypoglycemia in Patients with Type 2 Diabetes

BACKGROUND: We investigated whether an intensive individualized reinforcement education program could influence the prevention of hypoglycemic events in patients with type 2 diabetes. METHODS: From March 2013 to September 2013, patients aged 35 to 75 years with type 2 diabetes who had not previously participated in diabetes education, and treated with insulin or a sulfonylurea-containing regimen were included in the study. After structured group education, the patients assigned to the intensive individualized education group (IT) were requested to visit for reinforcement. All subjects in the IT were encouraged to self-manage dose adjustments. Participants in both groups (control group [CG, group education only; n=22] and IT [n=24]) attended follow-up visits at 2, 8, 12, and 24 weeks. At each visit, all patients were asked whether they had experienced hypoglycemia. RESULTS: The total study population consisted of 20 men (43.5%; mean age and diabetic duration of 55.9+/-11.0 and 5.1+/-7.3 years, respectively). At 24 weeks, there were no significant differences in hemoglobin A1c values between the CG and IT. The total number of hypoglycemic events per patient was 5.26+/-6.5 in the CG and 2.58+/-2.3 times in the IT (P=0.004). Adherence to lifestyle modification including frequency of exercise, self-monitoring of blood glucose, or dietary habit was not significantly different between the groups. However, adherence to hypoglycemia management, especially the dose adjustment of medication, was significantly higher in the IT compared with the CG. CONCLUSION: Compared with the structured group education, additional IT resulted in additional benefits in terms of avoidance of hypoglycemia and treating hypoglycemia in patients with type 2 diabetes.