Structured treatment and teaching of patients with Type 2 diabetes mellitus and impaired cognitive function--the DICOF trial
- PMID: 15317605
- DOI: 10.1111/j.1464-5491.2004.01281.x
Structured treatment and teaching of patients with Type 2 diabetes mellitus and impaired cognitive function--the DICOF trial
Abstract
Background: Patient education is integral part of any diabetes therapy in Germany, but elderly patients are not able to follow the variety of topics comprising standard treatment and teaching programmes (TTP), primarily due to impaired neuropsychological function. This leads to deficits in diabetes knowledge and hindered ability for diabetes self-management.
Aim: To evaluate structured TTP for geriatric patients with impaired cognitive function.
Patients and methods: A neuropsychological examination was performed on all patients over 54 years [n=102, age 68.6 +/- 8.7 years, diabetes duration 10.3 (0.03-35.4) years, HbA1c 10.3 +/- 1.7% (HPLC, Diamat, NR 4.5-6.3%), cognitive function 87.7 +/- 12.3 IQ points] who took part in TTP for insulin therapy. Patients with impaired cognitive function participated either in the standard TTP of Berger [n = 35, age 67.6 +/- 8.9 years, diabetes duration 9.9 (0.04-35.4) years, HbA1c 10.3 +/- 2.0%] or in the specialized structured geriatric DICOF-TTP [n=33, age 70.4 +/- 8.2 years, diabetes duration 10.4 (0.03-24.9) years, HbA1c 10.7 +/- 1.8%].
Results: After TTP there were no differences in knowledge and ability for diabetes self-management (standard/DICOF: knowledge 11.0 +/- 2.6 vs. 12.2 +/- 2.7 points, P = 0.11; handling 14.9 +/- 3.3 vs. 15.9 +/- 2.5 points, P = 0.18). However, patients who took part in the DICOF programme showed better scores in satisfaction with the education programme [standard/DICOF 44.7 (31-57) vs. 52.5 (45-59) points, P < 0.001]. Six months later the DICOF participants showed better results regarding diabetes self-management (standard/DICOF: handling 12.5 +/- 4.1 vs. 15.9 +/- 3.1 points, P = 0.001). Both groups showed HbA1c decrease (8.3 +/- 1.4 vs. 8.5 +/- 1.3%, P=0.62) and similar incidence of acute complications.
Conclusions: Elderly patients with impaired cognitive function should take part in specialized structured TTP. This leads to both better satisfaction with the education programme and an improved ability for diabetes self-management.
Similar articles
-
[A structured treatment and educational program for patients with type 2 diabetes mellitus, insulin therapy and impaired cognitive function (DikoL)].Med Klin (Munich). 2004 Jun 15;99(6):285-92. doi: 10.1007/s00063-004-1042-5. Med Klin (Munich). 2004. PMID: 15243988 Clinical Trial. German.
-
SGS: a structured treatment and teaching programme for older patients with diabetes mellitus--a prospective randomised controlled multi-centre trial.Age Ageing. 2009 Jul;38(4):390-6. doi: 10.1093/ageing/afp056. Epub 2009 May 18. Age Ageing. 2009. PMID: 19454403 Free PMC article. Clinical Trial.
-
Is it possible to predict improved diabetes outcomes following diabetes self-management education: a mixed-methods longitudinal design.BMJ Open. 2015 Nov 2;5(11):e008781. doi: 10.1136/bmjopen-2015-008781. BMJ Open. 2015. PMID: 26525722 Free PMC article.
-
An evaluation of an insulin transfer programme delivered in a group setting.J Clin Nurs. 2007 Jul;16(7B):152-8. doi: 10.1111/j.1365-2702.2007.01772.x. J Clin Nurs. 2007. PMID: 17584424 Clinical Trial.
-
[Management of type 2 diabetes: patient education].Presse Med. 2013 May;42(5):880-5. doi: 10.1016/j.lpm.2013.02.311. Epub 2013 Mar 21. Presse Med. 2013. PMID: 23523080 Review. French.
Cited by
-
Measurement properties of the brief resilient coping scale in patients with systemic lupus erythematosus using rasch analysis.Health Qual Life Outcomes. 2016 Sep 13;14(1):128. doi: 10.1186/s12955-016-0534-3. Health Qual Life Outcomes. 2016. PMID: 27619635 Free PMC article.
-
[Treatment quality in geriatric patients with diabetes mellitus in various home environments].Z Gerontol Geriatr. 2010 Dec;43(6):386-92. doi: 10.1007/s00391-010-0104-y. Epub 2010 Apr 18. Z Gerontol Geriatr. 2010. PMID: 20401505 German.
-
Diabetes self-management education (DSME) for older persons in Western countries: A scoping review.PLoS One. 2023 Aug 9;18(8):e0288797. doi: 10.1371/journal.pone.0288797. eCollection 2023. PLoS One. 2023. PMID: 37556399 Free PMC article.
-
[Diabetes and dementia].Z Gerontol Geriatr. 2012 Jan;45(1):17-22. doi: 10.1007/s00391-011-0269-z. Epub 2012 Jan 27. Z Gerontol Geriatr. 2012. PMID: 22278002 German.
-
Resilience in patients after allogeneic stem cell transplantation.Support Care Cancer. 2014 Feb;22(2):487-93. doi: 10.1007/s00520-013-2001-6. Epub 2013 Oct 8. Support Care Cancer. 2014. PMID: 24101151
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical