Re-training of type 2 diabetic patients for better adherence to diabetes care plan in oral anti-diabetics and plus insulin treatment groups

Abstract

Purpose: This prospective observational single-centre study was designed to evaluate the effect of patient re-training for better adherence to regular self-monitoring of blood glucose (SMBG), standard diabetic diet and exercise program in ambulatory patients with type 2 diabetes mellitus (T2DM) receiving oral anti-diabetic (OAD) and OAD plus insulin treatments.Material and Method: In this study, we enrolled a total of 61 patients with T2DM in whom ongoing therapy with OAD (n=34) and OAD+insulin (n=27) failed to achieve adequate glycemic control. The patients were educated for lifestyle behavior, adherence to diet and exercise therapy, close monitoring with SMBG without change in their ongoing drugs and dosing. Changes in glycemic parameters, serum lipids and anthropometrics at the end of 3rd month were compared between the treatment groups.Results: During the course of the study, a significant decrease in the body weight and fat were observed in OAD (p<0.001 and p=0.002) and OAD+insulin groups (p=0.044 and p=0.008, respectively). A significant decrease in the HbA1c % (6.1%; 8.2% to 7.6%) was observed in the overall population (p<0.001) as well as in OAD (p=0.011) and OAD+ insulin (p=0.001) groups. A significant decrease was noted in the post-prandial capillary blood glucose levels in only OAD+insulin group.Discussion: Re-training approach with close follow-up and frequent SMBG seems to be important factors for the maintenance of achieved glycemic control. In our study, the effect of diabetes education on postprandial capillary blood glucose levels was more pronounced in OAD+ insulin group.