The role of patient education in the prevention and management of type 2 diabetes: an overview

Abstract

The management of type 2 diabetes mellitus includes ability and empowerment of the patient to change lifestyle, maintain an adequate diet and physical activity, manage the disease, and follow a specific program of periodic medical checks and education sessions. In addition, the patient should be able to correctly identify and adequately solve problems related to the disease and actively collaborate with the healthcare system. To obtain these goals, therapeutic patient education (TPE) is now considered a crucial element not only in the treatment but also in the prevention of type 2 diabetes. Several trials showed that TPE is able to improve clinical, lifestyle, and psycho-social outcomes. Nevertheless, studies have not clarified the ideal characteristics of a comprehensive patient education program in clinical practice. Other work is needed to answer open questions regarding the type of PTE (individual or group education), themes, frequency and number of education sessions, contact time between educator and patient, background of educators, use of new technologies, and barriers to self-management. The present review discusses these points on the basis of the most recent data of the literature.

Structured therapeutic education in diabetes: is it time to re-write the chapter on the prevention of diabetic complications?

“…Diabetes mellitus is an epidemic, chronic condition characterized by increased morbidity, disability, and mortality because of frequent complications [1]. Complications mainly affect the heart, brain, limbs, eyes, nerves, and kidneys; in addition, most of the diabetic patients die from cardiovascular events [1].…”

“…Complications mainly affect the heart, brain, limbs, eyes, nerves, and kidneys; in addition, most of the diabetic patients die from cardiovascular events [1]. A strict glycemic control, together with the appropriate management of any associated risk factor, such as hypertension, dyslipidemia, obesity, and thrombotic risk, can significantly decrease the complications of diabetes [2][3][4].…”

“…The tight control of diabetes and other risk factors is usually obtained by treatments with specific medications [2][3][4]. Therapeutic patient education (TPE) is considered a central element of the management of diabetes [1]. Many studies have shown that a structured TPE is able to determine a significant improvement in several clinical, lifestyle, and psycho-social outcomes in people suffering from diabetes [1].…”

“…Therapeutic patient education (TPE) is considered a central element of the management of diabetes [1]. Many studies have shown that a structured TPE is able to determine a significant improvement in several clinical, lifestyle, and psycho-social outcomes in people suffering from diabetes [1]. However, there are a few data regarding the potential direct and indirect role that a structured TPE may have in the prevention of diabetic complications.…”

“…Indeed, a synergic effect between medications and TPE on the reduction of complications and death can be hypothesized for at least two reasons: (1) both can improve outcomes in an independent manner and therefore the positive effect may be additive; (2) TPE can optimize effects of medications because of an improvement in adherence [16]. However, if we assume that TPE can prevent the complications, other investigations should explain whether the effectiveness of TPE reported in the published studies [1,[6][7][8][9] can be further increased. At the moment, the ideal characteristics of TPE to give the best results in the management of diabetes and in the prevention of its complications are not defined [1,10].…”