| Objective:The purpose of this study was to compare structured education program with traditional diabetes education on HbAlc, insulin dosage, hypoglycemia episodes, insulin injection techniques, blood glucose, lipid profile, diabetes distress, and diabetes self-management skills. We intended to design an appropriate structured education program for type 2 diabetes patients on insulin injection.Methods:This was a randomized controlled trial.65 diabetic patients on insulin injection were randomly assigned to the intervention group (n=33) and control group (n=32). Participants in the control group were provided with 6-hour traditional didactic education and they can consult diabetes educators about self-management at any time. Subjects in the intervention group were supplied with structured education. They must complete 6 sessions of structured group education (1hour/session) then paid a clinic visit monthly. During each follow-up, the educator explored the achievement of behavior change and set new goals with the participants. Patients in both groups received education on insulin injection techniques individually. After 3 months, weight, HbAlc, blood glucose, and lipid profile were tested, in addition to this, insulin injection techniques, diabetes distress, diabetes self -management skills and quality of life were also evaluated.Results:71 patients were enrolled in the study,65 of them completed it (33 in the intervention group,32 in the control group). There was no significant difference (P>0.05) in baseline variables between the two groups. After the intervention, HbAlc, fasting blood glucose (FBG), postprandial blood glucose (PBG) were statistically significant lower in the intervention group than that in the control group (P<0.05). After 3 months, the insulin dosage decreased from 24.44±13.40 units to 15.19±11.56 units in the intervention group, meanwhile in the control group it dropped from 26.59±14.18 units to 20.84±17.69 units. Hypoglycemia episodes fell from 27.3% to 9.1% and 25.0% to 12.5% in the intervention group and control group respectively. Lipohypertrophy descended from 0.15±0.51 to 0.03±0.17 in the intervention group and from 0.25±0.80 to 0.22±0.71 in the control group. In the intervention group, reuse of needle dropped from 5.30±6.86 to 5.21±5.18, however, it was increased from 5.36±5.29 to 6.08±8.15 in the control group. In the intervention group, patients who rotated correctly increased from 60.6% to 78.8%, while in the control group, it was decreased from 68.8% to 65.6%. After 3 months, no statistically significant difference was identified between the two groups in scores of Diabetes Distress Scale (DDS) and Summary of Diabetes Self-Care Activities (SDSCA).Conclusion:1. After 3 months, compared to patients received traditional diabetes education, those attended structured education program achieved better HbA1c, FBG, and PBG.2. After 3 months, structured education program and traditional diabetes education had similar effects in decreasing diabetes distress and increasing diabetes self-management skills. |
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