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Not the kind of news I wanted to hear

May 07, 2012

Well – this is just swell (please note the sarcasm in my voice).  What a way to ruin my day!!

I was just reading an excerpt from an article published in the British Medical Journal, April 2012.

The article begins by saying several previous studies done in the UK had shown that the Diabetes Education and Self Management for Ongoing and Newly Diagnosed had been "successful in giving patients a positive outlook and that patients' feelings about their disease were improved." It was noted that the participants' health had benefitted over the next year but questions remained as to the long term effects of the study.

So,  a follow-up study was done looking at 731 people out of the 824 volunteers who had originally participated. The purpose was to look at the long term benefits over the 3 years after attending a diabetes education program.

The article reports that some participants had taken a 6 hour group class taught by "2 well trained healthcare professionals." This intervention group was compared to a control group that did not attend a structured class but followed the routine advice and care of their primary physicians.

Body weight, cholesterol levels and HbA1c data was collected on both groups. The researchers also looked at the patients' history of depression, medications, perceived quality of life, lifestyle habits, beliefs about illness and the patients’ feelings about having diabetes.

Unfortunately, after 3 years there was no difference in the lab data and lifestyle results in the two groups. I was disappointed to read that those who attended the 6 hour group class did not show an improvement in A1c levels over the control group. The article did mention that those who attended the structured class seemed to have improved in their beliefs about illness. 

How sad is that??? Those of us who are CDEs or involved in educating patients with diabetes KNOW that we are making a difference.  We see those patients who have dropped their A1c levels by 1, 2 or often by 3 points. We see the patients who have lost 15-35 pounds and tell us it was because of the diabetes self management class they attended.  My patients report more energy, more stamina and just generally feel better when their glucose values improve. I know that for every successful patient there are probably 3-4 patients who were not as successful. Often it is hard to determine if patients do not return because they are doing well and think they no longer need our services or do they not return because they did not see an immediate benefit to following the diabetes improvement plan.

Unfortunately, often studies such as this are used against us. In these days of budget cuts and reductions, this is not the news I wanted to hear.

7 comments

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  1. Jun 12, 2012

    It would have been nice to know more about what "well trained professionals" meant, the topics of the 6 hour class, and if the patients journaled their activities, food, blood sugar, etc. and if given follow up resources, such as diabetes support group. Thanks
  2. May 17, 2012

    This is very sad news. However, the trouble is that there is such limited ability to continue to support the clients progress. If those that have attended the "big class" were able to return every year for those same hours to refresh and support their progress, I believe the statistics would look much better. Without continued support people lose momentum. The saddest news of all is the trend of closing Diabetes Education Departments and Clinics as a cost-saving measure for hospitals that are struggling in the current economic paradigm. I believe in the long-term this will bring on even more financial hardship when clients begin using the hospital resources as a result of not understanding how to self-manage. I believe the key to long-term sucess is that initial intensive training followed by continued support.
  3. May 11, 2012

    Can someone tell me how did you study to take the Diabetes Certificate exam? What book or books did you use to help you study? I will be taking the exam in the fall? has anyone taken it recently? What did you use to study for the exam?
  4. May 09, 2012

    I too was disappointed but perhaps we need to think of this a an endorsement for DSMS. A physician does not treat a cancer patient for 6 hours one time and leave them to deal with their disease. On going treatment and support are necessary for any chronic process.
  5. May 09, 2012

    To Patricia Adams point, I think it also speaks to the need of improved communication between the patient and the physician. When we send the patient back to the physician after completing the DSME, is the physician asking the patient about the DSME experience? Is there any collaboration and support of the patient's goals? Is the patient discussing the DSME experience with their physician? It is a two way street. The ongoing discussion and support should occur at each encounter with both the patient and physician engaged in the process.
  6. May 08, 2012

    I think it speaks to the need for Diabetes Self Management Support. One session or group of classes with a diabetes educator isn't enough. People living with diabetes need a source of ongoing support
  7. May 08, 2012

    I question whether six hours of diabetes education by two "well trained professionals" is enough to make a difference?

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