Effects of a structured education program on glycemic control in type 1 diabetes

ABSTRACT Objective Diabetes mellitus is associated with significant morbidity and mortality, and education is known to play a key role in managing this disease. This study addresses the effects of a structured education program (SEP) on self-care in subjects with type 1 diabetes mellitus (T1DM). The aim was to evaluate the effect of a SEP on glycemic control, knowledge, and skills associated with diabetes care in subjects with T1DM. Subjects and methods A total of 47 adults with T1DM were followed up for 20 months (32 participated in the SEP and 15 served as a control group). The SEP consisted of workshops, individualized care, 24-hour distant support, and a questionnaire assessing knowledge of diabetes care. Glycosylated hemoglobin (HbA1c) levels were measured before and after the SEP implementation. Results Compared with pre-SEP levels, the mean HbA1c levels decreased by approximately 20% (21 mmol/mol) at 1 year, with a further 11% reduction (10 mmol/mol) observed 8 months later (p < 0.001). Knowledge about diabetes care increased by 37% between the pre-SEP and post-SEP questionnaires (p < 0.005). Conclusion Relevant improvements occurred after SEP activities. The sustained decrease in HbA1c levels and the overall increase in knowledge and confidence regarding diabetes care reinforce the importance, necessity, and positive outcomes of a SEP intervention in T1DM.

摘要
研究目的 糖尿病（Diabetes mellitus）与显著的发病率和死亡率密切相关，而教育在该病的临床管理中发挥关键作用。本研究探讨结构化教育项目（SEP）对1型糖尿病（T1DM）患者自我护理行为的影响，旨在评估该项目对1型糖尿病患者血糖控制、糖尿病护理相关知识与技能的作用。

研究对象与方法 本研究共纳入47名成人1型糖尿病患者，随访周期为20个月，其中32名患者参与结构化教育项目，剩余15名患者作为对照组。该结构化教育项目涵盖专题工作坊、个体化护理方案、24小时远程支持，以及用于评估糖尿病护理知识的调查问卷。分别在项目实施前后检测受试者的糖化血红蛋白（HbA1c）水平。

研究结果 与项目实施前的基线水平相比，患者的平均糖化血红蛋白水平在干预后1年时下降约20%（降幅达21 mmol/mol），并在随访至8个月时进一步下降11%（降幅达10 mmol/mol，P<0.001）。相较于项目实施前后的调查问卷结果，患者的糖尿病护理知识得分提升了37%（P<0.005）。

研究结论 实施结构化教育项目后，患者的相关健康指标得到显著改善。糖化血红蛋白水平的持续下降，以及糖尿病护理相关知识与自信心的整体提升，均证实了结构化教育项目干预对1型糖尿病患者的重要性、必要性与积极效果。