Long-term effects of an intensive-practical diabetes education program on HbA1c and self-care.

OBJECTIVE: The purpose of this study was to implement an intensive and practical diabetes education program (DEP) and evaluate its long-term effects and its impact on psychosocial variables. It was hypothesized that the DEP would improve patients' metabolic control (A1c hemoglobin - HbA1c), technical knowledge, self-efficacy and frequency of self-care and decrease barriers and other parameters such as the body mass index (BMI) and LDL cholesterol. These results should be maintained at one-year follow-up.

DESIGN AND SETTING: The sample was composed of 40 patients with diabetes type I who attended a diabetes outpatient clinic. A repeated measures design, considering medical and psychosocial variables at six months and one year, was used.

RESULTS: Results have statistical and clinical implications. They revealed significant changes that were maintained at one-year follow-up in HbA1c, barriers to self-care, frequency of self-care, knowledge about the disease and perceived self-efficacy. The areas of self-care where the fewest changes took place were diet and exercise, which are highly related to cardiovascular risk factors and are very present in patients with diabetes. Specifically, no changes were observed in BMI or LDL cholesterol.

CONCLUSION: The intensive DEP proved to be effective, although specific efforts should be made in certain areas to ensure longer-lasting benefits. Besides, including not only educational but also psychological strategies in patients' education to motivate them to make real lifestyle changes should be a priority in the design of any DEP.