If you show the appalling NHS results (highlighted in
the 2 following posts):
to a GP or a HCP they will often reply that the
results are due to the patient’s non-compliance or ignorance.
It is then of some interest to examine the results
for patients who have received the NHS diabetic education course for Type 1 and
Type 2 diabetes.
The structured education programme DAFNE (Dose
Adjustment For Normal Eating) is for Type 1 diabetes. A recent
publication:
assessed
HbA1c over a 7-year period following such a course. Over
the7 year period a reduction in HbA1c from an average of 8.6% to an average of
8.3% was achieved.
The DESMOND Programme (Diabetes
Education Self-Management On-going and Newly Diagnosed)
is for Type 2 diabetes. A recent publication:
concluded:
“a single programme for
people with newly diagnosed type 2 diabetes mellitus showed no difference in
biomedical or lifestyle outcomes at three years although there were
sustained improvements in some illness beliefs.”
Summarising:
Appalling diabetes statistics
Educational programmes bring no
significant improvement
The consequences for the future
are well known
A
recent publication:
Used information from national databases representing over 20 000
patients from 2005 to 2008, Scottish researchers led by Helen Colhoun from the
University of Dundee, found that people with type 1 diabetes have 2 to 3 times
the risk of heart attacks, strokes, or premature death than the general
population and that this increased risk is higher in women than in men. The
authors found that in those with type 1 diabetes, the risk (chance) of having a
cardiovascular event (heart attack or stroke) for the first time was 2.5 higher
in men and 3.2 higher in women, than in the general Scottish population.
Furthermore, in those with type 1 diabetes, death rates from any cause were 2.6
higher in men and 2.7 higher in women than in the general Scottish population.
Worryingly, the authors also found that the majority of patients in this
Scottish dataset had poorly controlled blood glucose levels, with only 13%
having HbA1c levels (a test that measures the blood sugar control over the
previous 3 months) in the target range.
They continue: "A striking feature of the data is the very low rate
of achievement of glycaemic control targets." The authors add: "Risk factor management should be improved to
further reduce risk but better treatment approaches for achieving good
glycaemic control are badly needed.”
What
better treatment approach for achieving good glycaemic control would you suggest?
John
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