- 5 Things I’ve Learned Living With Diabetes and Celiac Disease
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5 Things I’ve Learned Living With Diabetes and Celiac Disease
Get updates. Give today. Diabetes prevention: 5 tips for taking control. Products and services. Free E-newsletter Subscribe to Housecall Our general interest e-newsletter keeps you up to date on a wide variety of health topics. Sign up now.
Diabetes prevention: 5 tips for taking control Changing your lifestyle could be a big step toward diabetes prevention — and it's never too late to start. By Mayo Clinic Staff. References American Diabetes Association. Lifestyle management: Standards of Medical Care in Diabetes — Diabetes Care. Evert AB, et al. Nutrition therapy recommendations for the management of adults with diabetes.
American Diabetes Association. Accessed Aug. Physical activity. Colditz GA. Healthy diet in adults. Diabetes prevention program DPP. Accessed Feb. Perreault L. The results all pointed towards an improvement in metabolic control. The main limitation of our study was the lack of a control group. This would have reflected the true impact of the intervention on glycaemic control, as it is well known that such control tends to deteriorate over time. More important, it does not exclude the possibility that the improvement in glycaemic control was mostly due to the intensification of treatment, as it was greater in patients who switched from oral agents to insulin and in those who were already taking insulin.
However, the intensification itself may have been the result of a better understanding of the treatment of their diabetes due to the educational sessions. Another study limitation in terms of glycaemic control was the duration of follow-up. The initiation of our educational programme did not encounter any particular difficulties in the recruitment of private office-based diabetologists who, in some cases, had already been involved in previous educational programmes implemented at the out- or inpatient clinics at the hospital Department of Metabolic Diseases, Lapeyronie Hospital, Montpellier.
The problem was somewhat different for several general practitioners, who felt less comfortable with group education, at least at the beginning. When questioned as to their reasons for not doing so, they claimed a lack of time, an office space that was not big enough for a group session or having patients who were not motivated and difficult to convince to participate.
At six months, a number of patients lacked follow-up data. This was due in part to the fact that many patients with diabetes were mostly followed-up by their general practitioner and did not necessarily visit a diabetologist during the six-month period.
- The Prime Minister's speech at the opening of European Diabetes Leadership Forum 25 April 2012;
- To Those Newly Diagnosed with Diabetes: What We Wish You Knew;
- Bad Moon (Moonstruck Book 2).
However, we cannot exclude several biases. For instance, the patients were all volunteers and, as such, are different from the type 2 diabetic population in general. Another limitation was the duration of the training programme—only eight hours—for healthcare providers, both physicians and non-physicians. This was a compromise between a short baseline training period and a more complete one lasting several days. We were reluctant to offer more lengthy training because we believed that it would deter practitioners from participating in the programme. However, many participants, especially the diabetologists, had already benefited from other training sessions on educational topics.
Half of the education time was dedicated to nutritional education, as dietary compliance is a major problem in the general population of type 2 diabetic patients. Our patient questionnaire confirmed this: at the beginning of the study, At six months, the number of patients who wanted an interview with a dietitian had significantly dropped. Physical activity was promoted in general, although a specific exercise programme was not implemented, which very likely explains why there was no measurable impact improvements in levels of physical activity. Improving comprehension of the relationship between losing weight and improving metabolic parameters, and understanding the basis of medical decisions, probably contributed to better compliance with treatment and recommendations.
Assessment of group versus individual diabetes education. Evaluation of the impact of the programme was done through a questionnaire that had been modified to deal with the specific aspects of diabetes management covered during the group sessions as well as with quality of life. The questionnaire was designed to explore any interim action that could be taken.
Patient education is a complex intervention and difficult to evaluate. Nevertheless, is it possible to compare our programme with others? In German programmes, there was no decrease in HbA 1c , although a 2. The studies conducted by Trento et al. More recently, a meta-regression analysis compared different types of interventions aimed at improving diabetes care. The results of 38 trials of clinical education were analyzed, and the authors reported a 0.
They also noted that improvements were greater in the trials of a small number of patients compared with those involving large populations. Even though their education programmes were more intensively conducted than those offered to our patients, the clinical outcomes were similar.
Clinical education is not the only strategy tested for improving glycaemic control. In the meta-regression analysis of Shojania et al. For instance, the treatment of diabetes should not be limited solely to the management of glycaemic disorders, but should also cover cardiovascular risk factors such as hypertension, dyslipidaemia, sedentary behaviour, smoking and dietary control. These are all well-known factors for insulin resistance and the proinflammatory process encountered in diabetes. Multi-targeted and aggressive treatment of patients with type 2 diabetes at high risk: what are we waiting for?
Indeed, a more prolonged analysis would help to evaluate the impact of our programme on the long-term complications of type 2 diabetes. The present study provided data concerning the feasibility of implementing a group diabetes education programme in primary care and in a specialist subset of French patients with type 2 diabetes.
At six months, patients exhibited small improvements from baseline in fasting glucose and in all the main parameters of diabetes self-management assessed in the study.
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The results demonstrate that such a group programme, although limited in duration, favours better glycaemic control and overall management of the disease. It is to be hoped that we will be able to attract to diabetes education those patients who are younger and who have a higher baseline HbA 1c. In the management of a chronic disease such as diabetes, structured diabetic education is necessary. As medical care is becoming increasingly more technical, it is important that physicians and other healthcare providers collaborate in educational programmes.
Such programmes require an expertise and knowledge of the disease, and emphasize patient-empowerment techniques. The present data support the position of many experts, who claim that multitargeted aggressive management is necessary to reduce diabetes complications, and these goals require the intervention of multidisciplinary patient education.
drved.3callistos.com/12612.php We are grateful to Annie Lacroux, for her handling of the questionnaires and data management, to Isabelle Jaussent, who performed the statistical analyses, and to all the members of the Diabeduc Association. Journal page Archives Sommaire. Article Article Outline. Access to the text HTML. Access to the PDF text If you experience reading problems with Firefox, please follow this procedure.