Effect of Diabetes Education on Self-Care, Metabolic Control, and Emotional Well-Being

  1. Christopher D Saudek, MD
  1. Johns Hopkins Diabetes Center and Department of Medicine; and the Loyola College Center for Social and Community Research Baltimore, Maryland
  1. Address correspondence and reprint requests to Richard R. Rubin, PhD, 500 West University Parkway, Suite 1M, Baltimore, MD 21210.

Abstract

Participants (n = 165) entering a week-long outpatient education program completed a protocol measuring self-care patterns, glycosylated hemoglobin levels, and emotional well-being. Emotional well-being was reassessed at the end of the program, and the entire protocol was completed again at 6 mo (n = 124). At the program's end, participants improved on all measures of emotional well-being (P < .01). Self-esteem and diabetes self-efficacy rose, whereas anxiety and depression fell. At 6 mo, improvement in emotional well-being continued, and important self-care behaviors improved from preprogram levels. Self-monitoring of blood glucose and exercise rose (both P < .001), and binging (P < .01) and glycosylated hemoglobin levels (P < .001) fell. Program effects were unrelated to demographic or disease characteristics but strongly related to initial status. Participants who entered the program with high levels of emotional well-being or good self-care patterns or glycemic control tended to change little, if at all, at later measurements. On the other hand, people who entered the program with low levels of emotional well-being or with poor self-care patterns or glycemic control improved substantially. Our findings suggest that diabetes education can promote long-term benefits in self-care, metabolic control, and emotional status if the program is specifically designed to provide these benefits. Aspects of the program that contribute to its efficacy are discussed.

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