Type 2 diabetic patients attending a nurse educator have improved metabolic control

Abstract 

To investigate if routine education by nurses is associated with improved metabolic control in type 2 diabetic (DM2) outpatients, we randomly selected 143 patients (81 women), not using insulin, at the Endocrine or Internal Medicine clinics, to be interviewed and submitted to a clinical and laboratory evaluation. Age was 59.1±10.1 years; duration of DM2 7.5±6.3 years; BMI 29.7±5.2kg/m². Patients were grouped according to HbA_1c (<7.0% or ≥7.0%). Age, gender, DM2 duration, BMI, and lipid profile were not different. Patients with HbA_1c≥7.0% (n=49) were more likely to be taking oral agents, and to be treated by internists rather than endocrinologists (P=0.04). Nurse education was associated with a greater proportion of patients with HbA_1c<7.0%, especially among those attending the Internal Medicine clinic. In logistic regression, education by nurses remained associated to HbA_1c<7.0% (OR: 3.29, P=0.005), after controlling for use of oral agents (OR 0.067, P=0.01), attending the Endocrine clinic (OR 4.11, P=0.002), self-reported adherence to diet (“yes” or “no”), known DM duration, and instruction level (NS). Nurse education contributes significantly and independently for better metabolic control in DM2 outpatients in a teaching hospital.

Keywords: Type 2 diabetes melliltus, Education, Nurse, Metabolic control, Outpatients