ADA:
Effectiveness of a Diabetes Educator (DE) in Increasing Physician
Compliance with Type II Diabetes Case Management
DHE
presence in a private practice setting was effective at increasing
diabetic patient testing compliance for HbA1c, lipids and ALB.
Private
practice Type II diabetes management includes providing care and
testing according to established clinical guidelines. Previous studies
have shown that increasing physician knowledge is an important step in
better diabetes management.
Monitoring
compliance with testing provides evidence that knowledge is manifested
in better practice. This study examines if a Diabetes Health Educator
(DE) working within a private practice can have the measurable effect
on increasing patient testing.
A
part time (24 hour per-week) DE instructed private practice physicians
on current guidelines, standards and practices for diabetes case
management to a private practice with 362 diabetics. Physician
compliance with testing for hemoglobin (HbA1c), lipids and
micro-albumin (m-ALB) were then followed at one year intervals for two
years. Patients without direct DE involvement were treated as
controls. Analysis methods included chi-square test's between patients
followed by and DHE and those in the standard practice (controls).
The
results showed compliance with testing was equivalent (p>0.05) for
HbA1c, Lipids and m-ALB at baseline, demonstrating equality between
groups. Overall compliance rates at baseline were 62% for HbA1c, 63%
for Lipids and 35% for m-ALB. At one year physicians and patients with
the DE education component (n=258) increased compliance to 77% for
HbA1c versus 36% in the controls (p<0.001, n=104) at two years
compliance increase to 88% in the DE group and 63% in the controls
(p<0.002). Data for lipids demonstrated that DE education was 65%
compliant at one year compared to 30% in controls (p<0.001). At two
years compliance increased to 78% in DE education compared to 74% in
controls (p=0.556). Results were similar for m-ALB, with 100%
compliance in the first year (p<0.001) for DHE patients, and
reduced to 48% compliance in the second year (p=0.682)
The
study concluded that DE presence in a private practice setting was
effective at increasing diabetic patient testing compliance for HbA1c,
lipids and ALB. The lack of significance for the year two results
could best be explained as Hawthorne effect, indicating that
physicians have learned the diabetes management program and are
implementing HbA1c, lipid and m-ALB testing in all diabetic patients
in their practice without DE intervention. Further efforts are
continuing in making testing 'routine' in the private practice
setting. American
Diabetes Association's 62nd Annual Scientific Sessions
Did
you know? Soy
Supplements Help Blood Sugar
Women
with type 2 diabetes may help to keep their blood sugar and
cholesterol levels under control with soy supplements. That's the
finding of a study presented at the annual scientific sessions of the
American Diabetes Association. In the study, researchers looked at 32
postmenopausal women with type 2 diabetes. The women were given either
a dietary supplement with soy or one without soy for 12 weeks, then
given no supplements for two weeks, then switched to the other type of
supplement for another 12 weeks. The researchers found that after 12
weeks the women taking supplements with soy had significantly better
blood sugar control and lower levels of total cholesterol and
low-density lipoprotein ("bad" cholesterol). This could be
because soy contains substances called phytoestrogens, which act like
estrogen does in the body, the InteliHealth News Service reports. Some
studies have suggested estrogen could help prevent heart disease, but
results from other studies have been mixed. The researchers say more
study is needed to see if the benefits of soy supplements last, and if
they actually prevent heart disease.
