Health care and therapeutic education program for newly diagnosed type 2 diabetes: A new approach in primary care

Introduction: Despite the favorable evidence available, our public health care system has no specific programs including therapeutic education for patients newly diagnosed with type 2 diabetes (T2DM), which would be crucial for the subsequent course of the disease.

Objectives: To assess the effectiveness of a "Health care and Therapeutic Education Program for newly diagnosed type 2 diabetes (PAET-Debut DM2)" agreed by the primary care centers and the reference hospital in a given geographical area.

Methods: A prospective pilot study in patients over 18 years of age diagnosed with T2DM between February 2012 and 2013. The PAET-DebutDM2 is planned and set up in four primary care centers in the area covered by Hospital Clínic in Barcelona. Reference persons (family doctor and nurse) are designated at each center and specific training is provided to standardize the clinical processes and therapeutic education methods. First results are assessed and compared at 6 and 12 months.

Results: The program was proposed to 345 patients, of which 191 (55.3%) were enrolled in it and 134 (70.2%) completed the program. At the end of the program, 84% achieved the control goal (HbA1c <7%) and 88% passed the screening of chronic complications. Improvements were seen in body weight, physical activity (p<0,001), and disease awareness (p<0.05), and there were less hospital emergencies due to DM as compared to patients not included in the program (p=0.023).

Conclusion: The PAET-DebutDM2 standardizes intervention and education and is effective in terms of clinical and educational results and patient satisfaction. The program emphasizes the importance of early education and intervention, reorganizing resources without increasing care pressure in the primary care centers, thus reducing hospital care.