Diabetes education based on blood glucose pattern positively impacts self-care behaviors and self-efficacy in patients with type 2 diabetes, suggests a study published in the International Journal of Environmental Research and Public Health.¹

This study enrolled patients with type 2 diabetes, aged 18-70 years, visiting a hospital in South Korea from March to September 2017. None of the participants had ever received diabetes education. They were randomized to either a customized diabetes education program through pattern management with the help of continuous glucose monitoring system (CGMS) or a control group with an objective to evaluate the effect of diabetes education on individual self-care behaviors and self-efficacy.

Self-care behavior was measured with the help of a 4-item scale analysing answers to 20 questions pertaining to diet, medication, exercise and self-management. The scores ranged from “not at all” (score of 1) to “very well” (score of 4). Self-efficacy was measured using a questionnaire which examined patients on six aspects (healthy diet, monitoring of blood sugar and resolving problems with hypoglycemia, hyperglycemia problem solving, understanding treatment for the prevention of complications coping with medication and psychological difficulties). The scores on the 4-point scale ranged from 17 to 68.

Patients in the pattern management group underwent an hour of traditional diabetes education and continuous glucose monitoring test for 3 days. Based on the results of CGM, they underwent pattern-based diabetes education. A third education session was conducted via telephone. The before and after results were examined at 3 and 6 months. The control group received just the traditional diabetes education.

Results showed a marked difference with regard to self-care behaviors between the two groups. In 3 months after the diabetes education program, the score increased by 0.38 in the pattern management group vs the control group. Increase in the scores for diet-related, exercise-related and self-management-related questions was noted in the pattern management group denoting significant changes in self-care behaviors. At six months, the score decreased by 0.27 in the pattern management group than in the control group. Improvement in medication-related self-care behaviors was also observed, though this difference was non-significant.

When self-efficacy was examined, again a significant between-group difference was observed. At 3 months, the self-efficacy score increased markedly, by 0.51, in the pattern management group vs the control group. Scores for all six sub-domains of self-efficacy were increased. At 6 months, the difference in the reduction between the two groups was similar (0.04).

The HbA1c decreased from 9.62 at baseline to 7.72 at six months after the education program in the PM group. In the control group, the mean HbA1c was 9.69 before the education program and 8.20 six months after the program.

Today is World Diabetes Day and the theme this year is “access to diabetes education”.

In this study, Lee et al examined the impact of diabetes education based on pattern management on self-care behaviors and self-efficacy of patients with type 2 diabetes using CGMS as a tool. Pattern management is assessment of blood glucose values to identify a pattern and to also examine the effect of factors such as dietary habits, physical activity, stress, anti-diabetic medication on the blood glucose levels. This information facilitates active patient participation in treatment.

It further establishes that alterations in blood glucose as identified on continuous glucose monitoring significantly changed self-efficacy and self-care behaviors resulting in optimal and effective glycemic control in the pattern management group. Diabetes education empowered patients to better cope with their disease and incorporate healthy lifestyle behaviors in daily life.

In this age of precision medicine, the study further highlights the need for personalized diabetes education programs so that the improvement in self-care behaviors and self-efficacy can be sustained since a decline in self-efficacy was observed after 3 months of diabetes education in this study. It also suggests CGMS as a useful aid in developing diabetes education programs tailored to the individual needs of the patient.

Reference

1. Sung-Kyoung Lee, et al. Effect of diabetes education through pattern management on self-care and self-efficacy in patients with type 2 diabetes. Int J Environ Res Public Health. 2019 Sep 9;16(18):3323. doi: 10.3390/ijerph16183323.