Effects of a Therapeutic Patient Education Network on the Glycated Hemoglobin and Body Mass Index in 59 Patients with Type 2 Diabetes Mellitus: A Retrospective Study from 2013 to 2018

Abstract

can An education was created of the Aisne region of France. With hindsight, what has been the impact of a TPE network like this one? Objectives: The main objective of the study was to assess the effects of unstable type 2 diabetic (T2DM) patients’ participation in the activities of an education network on body mass index (BMI) and glycated hemoglobin (HbA1c). These patients were monitored from January 2013 to June 2018. The secondary objective was to determine the impact of adapted physical activity sessions (APA) and of TPE on the two selected clinic-biological parameters. Methods: A retrospective, quantitative, and monocentric, observational study was performed with analysis of the evolution of HbA1c and BMI of T2DM patients. They were monitored for more than six months in the network between 2013 and 2018, using the Logireso® database. Statistical analysis was performed using SPSS® software. BMI and HbA1c were analyzed by Student›s T test for paired samples. A linear regression test was performed to assess whether there is a correlation between two variables among those measured. Results: Fifty-nine patients met the inclusion criteria (20.92% of participants in the network). The decreases in BMI (–1.65 kg/m²) and HbA1c (–0.86%) of the patients studied were significant (p < 0.001). This change was even more drastic for patients with higher initial values of BMI and HbA1c (result for the highest bracket). However, the study did not link APA or TPE sessions to changes in BMI or HbA1c. Conclusion: The study showed the overall effectiveness of the proposed program in reducing BMI and HbA1c without highlighting a single factor that could explain it. evaluated made it possible to meet the objective to evaluate the effects of the network on the BMI and HbA1c of patients with type 2 diabetes mellitus monitored from January 2013 to June 2018. This study showed that an improvement in BMI measurements (–1.65 kg/m²) and HbA1c (–0.86%) was found in 59 patients with unbalanced type 2 diabetes at the end of an educational course including patient therapeutic education sessions and adapted physical activities. Only 59 patients were included in the analysis over a period spanning five and a half years, mainly due to a lack of data collected despite the request for supplements from the two laboratories and general practitioners of the city. The number of subjects studied in this research is relatively small compared to the prevalence of diabetes in the general population. It is thus legitimate to wonder whether the presence of insignificant results is a consequence of a possible lack of power in the study. Only the drop in HbA1c could be correlated statistically with participation in the network. This is probably secondary to multiple factors that could not be differentiated in this study (new treatment for exemple). The results obtained were similar to those found in the literature (Deakin et al., 2005; Trento et al., 2004).