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Education as Prescription for Patients with Type 2 Diabetes Mellitus: Compliance and Efficacy in Clinical Practice
Mi Yeon Kim, Sunghwan Suh, Sang-Man Jin, Se Won Kim, Ji Cheol Bae, Kyu Yeon Hur, Sung Hye Kim, Mi Yong Rha, Young Yun Cho, Myung-Shik Lee, Moon Kyu Lee, Kwang-Won Kim, Jae Hyeon Kim
Diabetes Metab J. 2012;36(6):452-459.   Published online December 12, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.6.452
  • 4,553 View
  • 33 Download
  • 12 Crossref
AbstractAbstract PDFPubReader   
Background

Diabetes self-management education has an important role in diabetes management. The efficacy of education has been proven in several randomized trials. However, the status of diabetes education programs in real Korean clinical practice has not yet been evaluated in terms of patient compliance with the education prescription.

Methods

We retrospectively analyzed clinical and laboratory data from all patients who were ordered to undergo diabetes education during 2009 at Samsung Medical Center, Seoul, Korea (n=2,291). After excluding ineligible subjects, 588 patients were included in the analysis.

Results

Among the 588 patients, 433 received education. The overall compliance rate was 73.6%, which was significantly higher in the subjects with a short duration or living in a rural area compared to those with a long duration (85.0% vs. 65.1%, respectively; P<0.001) or living in an urban area (78.2% vs. 70.4%, respectively; P=0.037). The hemoglobin A1c decreased greater in the compliant group (from 7.84±1.54 at baseline to 6.79±1.06 at 3 months and 6.97±1.20 at 12 months after prescription in the compliant group vs. from 7.74±1.25 to 7.14±1.02 and 7.24±1.24 in the non-compliant group; P=0.001). The decrease in hemoglobin A1c was greater in the subjects with a short duration (P=0.032).

Conclusion

In our study a large percent of patients refuse to get education despite having a prescription from their physician. This refusal rate was higher in the patients with long-standing diabetes or in urban residence. Furthermore, education was more effective in patients with a short duration of diabetes in clinical practice.

Citations

Citations to this article as recorded by  
  • Clinical Effects of a Home Care Pilot Program for Patients with Type 1 Diabetes Mellitus: A Retrospective Cohort Study
    Sejeong Lee, KyungYi Kim, Ji Eun Kim, Yura Hyun, Minyoung Lee, Myung-Il Hahm, Sang Gyu Lee, Eun Seok Kang
    Diabetes & Metabolism Journal.2023; 47(5): 693.     CrossRef
  • Management Status of Patients with Type 2 Diabetes Mellitus at General Hospitals in Korea: A 5-Year Follow-Up Study
    Jin Hee Jung, Jung Hwa Lee, Hyang Mi Jang, Young Na, Hee Sun Choi, Yeon Hee Lee, Yang Gyo Kang, Na Rae Kim, Jeong Rim Lee, Bok Rye Song, Kang Hee Sim
    The Journal of Korean Diabetes.2022; 23(1): 64.     CrossRef
  • The Effectiveness of Multidisciplinary Team-Based Education in the Management of Type 2 Diabetes
    Jong Ho Kim, Yun Jeong Nam, Won Jin Kim, Kyung Ah Lee, A Ran Baek, Jung Nam Park, Jin Mi Kim, Seo Young Oh, Eun Heui Kim, Min Jin Lee, Yun Kyung Jeon, Bo Hyun Kim, In Joo Kim, Yong Ki Kim, Sang Soo Kim
    The Journal of Korean Diabetes.2018; 19(2): 119.     CrossRef
  • The diabetes self-management educational programs and their integration in the usual care: A systematic literature review
    Emmanuel Kumah, Giulia Sciolli, Maria Laura Toraldo, Anna Maria Murante
    Health Policy.2018; 122(8): 866.     CrossRef
  • Diabetes Camp as Continuing Education for Diabetes Self-Management in Middle-Aged and Elderly People with Type 2 Diabetes Mellitus
    So Young Park, Sun Young Kim, Hye Mi Lee, Kyu Yeon Hur, Jae Hyeon Kim, Moon-Kyu Lee, Kang-Hee Sim, Sang-Man Jin
    Diabetes & Metabolism Journal.2017; 41(2): 99.     CrossRef
  • Educational attainment moderates the associations of diabetes education with health outcomes
    Su Hyun Kim
    International Journal of Nursing Practice.2016; 22(5): 444.     CrossRef
  • Experiences of Diabetes Education among Educators of Diabetes : a content analysis approach
    Soo Jin Kang, Soo Jung Chang
    Journal of Korean Public Health Nursing.2016; 30(2): 221.     CrossRef
  • Barrier Factors to the Completion of Diabetes Education in Korean Diabetic Adult Patients: Korea National Health and Nutrition Examination Surveys 2007-2012
    Hee-Tae Kim, Kiheon Lee, Se Young Jung, Seung-Min Oh, Su-Min Jeong, Yoon-Jung Choi
    Korean Journal of Family Medicine.2015; 36(5): 203.     CrossRef
  • Determinants of glycaemic control in a practice setting: the role of weight loss and treatment adherence (The DELTA Study)
    C. McAdam‐Marx, B. K. Bellows, S. Unni, J. Mukherjee, G. Wygant, U. Iloeje, J. N. Liberman, X. Ye, F. J. Bloom, D. I. Brixner
    International Journal of Clinical Practice.2014; 68(11): 1309.     CrossRef
  • Health education via mobile text messaging for glycemic control in adults with type 2 diabetes: A systematic review and meta-analysis
    Mohsen Saffari, Ghader Ghanizadeh, Harold G. Koenig
    Primary Care Diabetes.2014; 8(4): 275.     CrossRef
  • The Appropriateness of the Length of Insulin Needles Based on Determination of Skin and Subcutaneous Fat Thickness in the Abdomen and Upper Arm in Patients with Type 2 Diabetes
    Kang Hee Sim, Moon Sook Hwang, Sun Young Kim, Hye Mi Lee, Ji Yeun Chang, Moon Kyu Lee
    Diabetes & Metabolism Journal.2014; 38(2): 120.     CrossRef
  • Diabetes Attitudes, Wishes and Needs second study (DAWN2™): Cross‐national benchmarking of diabetes‐related psychosocial outcomes for people with diabetes
    A. Nicolucci, K. Kovacs Burns, R. I. G. Holt, M. Comaschi, N. Hermanns, H. Ishii, A. Kokoszka, F. Pouwer, S. E. Skovlund, H. Stuckey, I. Tarkun, M. Vallis, J. Wens, M. Peyrot
    Diabetic Medicine.2013; 30(7): 767.     CrossRef
Smaller Mean LDL Particle Size and Higher Proportion of Small Dense LDL in Korean Type 2 Diabetic Patients
Sunghwan Suh, Hyung-Doo Park, Se Won Kim, Ji Cheol Bae, Alice Hyun-Kyung Tan, Hye Soo Chung, Kyu Yeon Hur, Jae Hyeon Kim, Kwang-Won Kim, Moon-Kyu Lee
Diabetes Metab J. 2011;35(5):536-542.   Published online October 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.5.536
  • 4,850 View
  • 39 Download
  • 14 Crossref
AbstractAbstract PDFPubReader   
Background

Small dense low density lipoprotein (sdLDL) has recently emerged as an important risk factor of coronary heart disease.

Methods

The mean LDL particle size was measured in 203 patients with type 2 diabetes mellitus (T2DM) and 212 matched subjects without diabetes using polyacrylamide tube gel electrophoresis. Major vascular complications were defined as stroke, angiographically-documented coronary artery disease or a myocardial infarction. Peripheral vascular stenosis, carotid artery stenosis (≥50% in diameter) or carotid artery plaque were considered minor vascular complications. Overall vascular complications included both major and minor vascular complications.

Results

Diabetic patients had significantly smaller mean-LDL particle size (26.32 nm vs. 26.49 nm) and a higher percentage of sdLDL to total LDL compared to those of subjects without diabetes (21.39% vs. 6.34%). The independent predictors of sdLDL in this study were serum triglyceride level and body mass index (odds ratio [OR], 1.020 with P<0.001 and OR 1.152 with P<0.027, respectively). However, no significant correlations were found between sdLDL and major vascular complications (P=0.342), minor vascular complications (P=0.573) or overall vascular complications (P=0.262) in diabetic subjects.

Conclusion

Diabetic patients had a smaller mean-LDL particle size and higher proportion of sdLDL compared to those of subjects without diabetes. Obese diabetic patients with hypertriglyceridemia have an increased risk for atherogenic small dense LDL. However, we could not verify an association between LDL particle size and vascular complications in this study.

Citations

Citations to this article as recorded by  
  • Evaluation of measured and calculated small dense low-density lipoprotein in capillary blood and association with the metabolic syndrome
    Sara Deza, Inmaculada Colina, Oscar Beloqui, José Ignacio Monreal, Estéfani Martínez-Chávez, Julia Maroto-García, Carmen Mugueta, Alvaro González, Nerea Varo
    Clinica Chimica Acta.2024; 557: 117897.     CrossRef
  • Association between measured or calculated small dense low‐density lipoprotein cholesterol and oxidized low‐density lipoprotein in subjects with or without type 2 diabetes mellitus
    Hyun‐Ki Kim, Jinyoung Hong, Sunyoung Ahn, Woochang Lee, Sail Chun, Won‐Ki Min
    Journal of Clinical Laboratory Analysis.2023;[Epub]     CrossRef
  • The association of apolipoprotein in the risk of ST-elevation myocardial infarction in patients with documented coronary artery disease
    Astuti Giantini, Nur Gifarani Pratiwi, Renan Sukmawan, Joedo Prihartono, Suzanna Immanuel, Merci Monica Pasaribu, Sri Suryo Adiyanti, Yusuf Bahasoan
    International Journal of Cardiology Cardiovascular Risk and Prevention.2023; 18: 200194.     CrossRef
  • Atherogenic Index of Plasma and Its Association with Risk Factors of Coronary Artery Disease and Nutrient Intake in Korean Adult Men: The 2013–2014 KNHANES
    Hye Ran Shin, SuJin Song, Jin Ah Cho, Sun Yung Ly
    Nutrients.2022; 14(5): 1071.     CrossRef
  • The Atherogenic Index of Plasma: A Powerful and Reliable Predictor for Coronary Artery Disease in Patients With Type 2 Diabetes
    Kuo Zhou, Zheng Qin, Jinfan Tian, Kongyong Cui, Yunfeng Yan, Shuzheng Lyu
    Angiology.2021; 72(10): 934.     CrossRef
  • Direct bilirubin is associated with low-density lipoprotein subfractions and particle size in overweight and centrally obese women
    Y.-J. Kwon, H.-S. Lee, J.-W. Lee
    Nutrition, Metabolism and Cardiovascular Diseases.2018; 28(10): 1021.     CrossRef
  • Correlation between Cholesterol, Triglycerides, Calculated, and Measured Lipoproteins: Whether Calculated Small Density Lipoprotein Fraction Predicts Cardiovascular Risks
    Sikandar Hayat Khan, Nadeem Fazal, Athar Abbas Gilani Shah, Syed Mohsin Manzoor, Naveed Asif, Aamir Ijaz, Najmusaqib Khan Niazi, Muhammad Yasir
    Journal of Lipids.2017; 2017: 1.     CrossRef
  • Effects of Small Dense LDL in Diabetic Nephropathy in Females with Type 2 Diabetes Mellitus
    Seongyul Ryu, Youngwoo Kim, Mee Kyoung Kim, Hyuk-Sang Kwon, Ki-Hyun Baek, Ki-Ho Song, Kyung-Jin Yun
    Journal of Lipid and Atherosclerosis.2016; 5(1): 11.     CrossRef
  • Prepregnancy Adverse Lipid Profile and Subsequent Risk of Gestational Diabetes
    Emily S. Han, Ronald M. Krauss, Fei Xu, Sneha B. Sridhar, Assiamira Ferrara, Charles P. Quesenberry, Monique M. Hedderson
    The Journal of Clinical Endocrinology & Metabolism.2016; 101(7): 2721.     CrossRef
  • Meta-analysis of Atherogenic Index of Plasma and other lipid parameters in relation to risk of type 2 diabetes mellitus
    Xiao-Wei Zhu, Fei-Yan Deng, Shu-Feng Lei
    Primary Care Diabetes.2015; 9(1): 60.     CrossRef
  • Higher levels of small dense low‐density lipoprotein (LDL) are associated with cardiac autonomic neuropathy in patients with Type 2 diabetes
    E.‐H. Jang, Y.‐M. Park, J. Hur, M.‐K. Kim, S.‐H. Ko, K.‐H. Baek, K.‐H. Song, K.‐W. Lee, H.‐S. Kwon
    Diabetic Medicine.2013; 30(6): 694.     CrossRef
  • Sleep Status and Low-Density Lipoprotein Particle Size in a General Japanese Female Population: The Mima Study
    Kazuhiko Kotani, Kokoro Tsuzaki, Shinji Fujiwara, Naoki Sakane
    Medical Principles and Practice.2013; 22(5): 510.     CrossRef
  • Serum small-dense LDL abnormalities in chronic renal disease patients
    M. Chu, A. Y. M. Wang, I. H. S. Chan, S. H. Chui, C. W. K. Lam
    British Journal of Biomedical Science.2012; 69(3): 99.     CrossRef
  • Small Dense Low-density Lipoprotein and Cardiovascular Disease
    Sunghwan Suh, Moon-Kyu Lee
    Journal of Lipid and Atherosclerosis.2012; 1(1): 1.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal