EVALUATION OF THE EFFECTIVENESS OF AN AMBULATORY TEACHING TREATMENT PROGRAM FOR NON-INSULIN-DEPENDENT (TYPE-2) DIABETIC-PATIENTS/

The aim of this study was to evaluate the effect of a structured teach ing/treatment programme on the clinical and metabolic control of non-i nsulin-dependent (type 2) diabetic patients. The programme was aimed a t improving the overall treatment quality in these patients through me asures involving self-care, diet, exercise and weight reduction. Four theoretical-practical teaching units were given once a week to group o f 5-8 ambulatory patients by previously trained general practitioners. Clinical and biochemical parameters were recorded at the beginning of the course and 1 year after its completion in 40 patients attending t he programme and in 39 patients of similar clinical characteristics un der conventional diabetes treatment, but receiving no structured teach ing before or during the survey period (control group). The drop-out p ercentage in the intervention group (25%) was significantly lower than in the control group (45%, P<0.05), suggesting an incentive toward gr eater compliance in the former. At the end of the 1-year follow-up, th e mean differences observed in the control and in the intervention gro ups were: body weight loss -2.4+/-0.5kg vs -0.4+/-0.5 (P<0.001); haemo globin HbA(1) -0.2%+/-0.4% vs +0.8%+/-0.4% (NS); number of daily oral hypoglycaemic agent intake -1.4+/-0.2 vs +0.9+/-0.2 tablets (P<0.001). Our results strongly suggest that this programme, applied through fam ily doctors, may constitute an efficient tool to improve the complianc e and clinico-metabolic control of type 2 patients at the primary heal th care level.