Patient diabetes education in the management of adult type 2 diabetes

Corabian P, Harstall C
Record ID 32001000087
Authors' objectives: This report is a systematic review and critical apraisal of the literature on the use of formal outpatient diabetes education as a therapeutic tool for self-management in adult patients with type 2 diabetes.
Authors' recommendations: The published reports on the effectiveness of patient diabetes education (PDE) as a tool to promote self-management in adults with type 2 diabetes produced mixed results in terms of improved metabolic control and reduced risks for diabetes-associated complications in the long-term. The results are not directly comparable since investigators have used different designs, PDE programs, patient populations, sample sizes, follow-up periods, types of outcome and outcome measures. Also, the inadequate data presentation limited the interpretation of the available evidence. The long-term diabetes control outcomes of formal PDE when used to promote self-management in adults with type 2 diabetes have yet to be defined and appropriate measures established. The available evidence did not permit to draw reliable conclusions on: - which types of programs or what components are most effective in improving the ability of adults with type 2 diabetes to self-manage their disease; or - which category of patients might benefit most. This review confirmed results of previous ones: - there is no consistent pattern of effect across outcomes based on type of intervention, length of educational intervention, core team composition or type of educational setting; and - there is no standard method to describe formal PDE programs and interventions, thus making it difficult to replicate studies. Findings from qualitative research studies were useful in illuminating the findings from quantitative research studies, by helping to understand better the context in which formal PDE should be applied to be successful in promoting self-management behaviors in adults with type 2 diabetes. The administrators of formal PDE programs need to consider that the trends in formal PDE delivery call for: - an ongoing patient-centered PDE approach, described as a step-by-step process which involves the diabetes care and education providers, the patients and their caregivers; - focus on meeting the patient-s needs and overcoming patient's barriers to self-management behaviors, and continuous reinforcement of patient's positive behaviors, besides transmission of knowledge and skills; - the development of trustful patient-educator relationships and the existence of good partnership with the other members of the diabetes management team; - measurement of PDE success in terms of both long-term outcomes and short-term outcomes, regardless of PDE approach. - data collected for each outcome by using a more standardized set of validated instruments.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Diabetes Mellitus
  • Patient Education as Topic
Organisation Name: Institute of Health Economics
Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;
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Copyright: <p>Alberta Heritage Foundation for Medical Research (AHFMR)</p>
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