Long-term results of therapeutic education of patients with type 1 diabetes mellitus

The paper presents the results of a prospective (13-year) study of the effectiveness of a diabetes teaching and treatment program (DTTP) for patients with type 1 diabetes mellitus. The patients were divided into two subgroups according to the frequency of follow-up visits to the Endocrinology Research Center, Russian Academy of Medical Sciences. The intensive follow-up subgroup comprised the patients who had visited the center at least every 4-6 months after DTTP (Group 1). These visits had included regular measure-ments of the level of HbA_1c; recommendations on insulin dosage adjustment regimens; discussion of the results of glycemia self-monitoring according to the patient's diabetes diary, etc. The other subgroup consisted of the patients who were followed up only in the urban health care system. The baseline compensation of carbohydrate metabolism was poor. Subgroup analysis of the changes in the level of HbA_1c indicated that Group 1 patients had its significantly lower levels 7 and 13 years after DTTP. There was an inverse correlation between the level of HbA_1c and the rate of glycemia self-monitoring. The study demonstrated the high effectiveness of DTTP in reducing the incidence of acute and chronic complications of diabetes mellitus, the number of hospital admissions for diabetes and sick leave days throughout the follow-up.

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