Objetivo: Evaluar el efecto de la intervención educativa en el control
metabólico de los pacientes diabéticos tipo 2 del Hospital Nacional Arzobispo Loayza en Lima - Perú.
Los promedios de HbA1c disminuyeron significativamente en ambos grupos
durante todo el estudio pero solo a los 6 meses el grupo PEBADIM
presento concentraciones de HbA1c menores al grupo control (7.5% +/-
1.5 % versus 8.8 % +/- 1.4%), La proporción de pacientes con HbA1c
controlada (< 7%) en el grupo PEBADIM se incrementó desde 12.1%
hasta 54.3% a los 6 meses, lo cual se diferencia significativamente
del grupo control que incrementó la proporción de pacientes
controlados desde 11.1 % al inicio hasta 35.8 % a los 6 meses (X2 =
3.93, p = 0.04). Posteriormente la proporción de pacientes
controlados disminuye en ambos grupos.
Conclusión: La intervención educativa PEBADIM fue efectiva en
mejorar el control metabólico de los pacientes con DM 2 con relación
al grupo control; constituyendo un modelo que puede servir de base
para facilitar el desarrollo de nuevos programas educativos en
diabetes en el ámbito nacional.
SUMARY
Introduction: Type 2 diabetes mellitus and their long-terms
complications could be prevented with medical care and educational
intervention.
Objetive: To evaluate the effect of Diabetes Basic Education
Program on the metabolic control of type 2 diabetes mellitus patients
at Arzobispo Loayza National Hospital in Lima Peru.
Material and Methods
Research Design: Experimental.
Population: Patients with type 2 diabetes mellitus with following
inclusion criteria a) Definite type 2 diabetes mellitus. b) Age <
78 years, c) Ambulatory medical care > 9 months and d) Reside on
Lima Peru.
Intervention Group: 107 patients who received the intervention at the
Diabetes Basic Education Program.
Control Group: 121 patients without intervention.
Intervention targeting aspects of knowledge about diabetes, metabolic
control, prevention, diagnosis and treatment of long-term
complications, dietary, exercise and use of medications.
We measure Fast Plasmatic Glucose (FPG), post prandial glucose,
glycated hemoglobin (HbA1c), lipid profile, blood pressure, weight,
body mass index, and renal function at baseline, 3, 6, and 9 months
after started the study.
Results: Age, women proportion, weight, BMI, blood pressure,
FPG, post prandial glucose, HbA1c, lipid profile and renal function
were similar between both groups at baseline.
Intervention group had lower FPG and post prandial glucose from first
to last control (t Student, p < 0.05). Patient proportions with FPG
controlled (< 110 mg%) at baseline were similar between both groups
(5.7 % vs. 3.5 %), these increased to 48.7% on intervention group at 6
month versus 33.8% on control group respectively (X2 = 4.4, p =
0.03).
Means of HbA1c decreased during all study in both groups, but only at
6th month the intervention group had lower concentration of HbA1c than
control group (7.5% +/- 1.5 % versus 8.8 % +/- 1.4%; t de Student p
< 0.05). Patient proportions with HbA1c controlled (< 7 %)
increased from 12.1% to 54.3% at 6th month in the intervention group;
it was different of controls that increased from 11.1 % to 40.5% at
6th month (X2 = 3.93, p=0.04). After it controlled patient proportions
diminished in both groups.
Conclusion: We improve metabolic control (FPG, post prandial
glucose and glycated hemoglobin) in patients of intervention group.
These findings could establish a model to implement new educational
programs at national level.
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