Lyon, C., Fields, H., Langner, S., & DeSanto, K. (2018). Diabetes education and glycemic control. American Family Physician , 97 (4), 269-270. www.aafp.org/afp
In the article, “Diabetes education and glycemic control,” Lyon et al. (2018) carry out a meta-analysis of randomized controlled trials (RCTs) tackling the effects of patient education on glycemic control. They seek to determine if counseling of patients with type 2 diabetes mellitus improves their A1C levels. To achieve their objective, they compare the A1C levels of patients who receive diabetes education and those who receive routine care. The authors divided the analysis into three phases, each designed to reinforce the evidence that answers their clinical question.
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The first phase examined 21 RCTs that focused on self-management education and routine care and their effects on the A1C level. The RCTs covered 2,833 participants with the intervention groups receiving education sessions for at least six months in a primary care setting. In the group that received an education, A1C levels reduced with a mean difference of between –0.44% to –0.87%. In the second phase, the effects of individual instruction and group education were compared. An analysis of 1,359 adults showed that individual education did not have A1C improvements that differed from those in routine care after six months. However, patients with an A1C greater than 8% and on individual education had a more significant A1C decrease than those in regular care. Group education performed better than individual education after six to nine months of diabetes education. The third phase compared unique diabetic education interventions with usual care. After a randomized sampling of patients on unique education interventions, their average A1C reduction was -0.74% compared to -0.17% of those on routine care. The authors concluded that diabetes education reduced A1C by 0.2% to 0.8% more than usual care. More significant improvement is achieved among patients with an average baseline of above 8%. The article recommends that patients receive diabetes self-management education at diagnosis and during follow-up.
Reference
Lyon, C., Fields, H., Langner, S., & DeSanto, K. (2018). Diabetes education and glycemic control. American Family Physician , 97 (4), 269-270. www.aafp.org/afp
