Integration of Diabetes Education in Type 2 Diabetes Care

General knowledge of diabetes, adherence to medication, lifestyle changes, and selfmonitoring of blood glucose are surrogate end points. Diabetes self-management training programs should emphasize the need for a multifaceted attack against the risk factors for both macro- and microvascular disease, be collaborative and have repetitive educational sessions. Because a target-driven attitude of diabetes care providers is of major importance, the integration of education in daily practice is important. An educational programme by a diabetes nurse in 54 type 2 diabetes patients treated in primary care with maximal dosages of oral hypoglycemic agents but with HbA 1c ≥7.0 led to a clinically relevant improvement in HbA 1c level without any change of medication. The lack of structured follow-up resulted in disappointing effects on the long-term. Questions remain as to the extent of which the different parts of the programme contributed to the result. Nevertheless, because the course was short and the educational materials were simple and cheap, it could be embedded in daily practice, on the condition that a well-trained and confident practice/diabetes nurse is available. Effective diabetes self-management programs must be noncomplex, individualized to a person’s lifestyle, reinforced over time and respecting an individual’s habits, they should primarily focus on medication adherence, be cheap and very practical.