- Email: [email protected]
Response to van de Sande et al. “The relationship between patient education and glycaemic control in a South African township, Prim. Care Diabetes 1 (2) (2007) 87–91”
p r i m a r y c a r e d i a b e t e s 2 ( 2 0 0 8 ) 105
available at www.sciencedirect.com
journal homepage: http://www.intl.elsevierhealth.com/journals/pcd/
Letter to the Editor
Response to van de Sande et al. “The relationship between patient education and glycaemic control in a South African township, Prim. Care Diabetes 1 (2) (2007) 87–91”
Dear Editor, I was pleased to read the recent report by van de Sande et al., which highlights the key role of education in the global fight against diabetes and its complications [1]. Their epidemiological study, set in a South African township, evaluated the relationship between patients’ glycaemic control and their knowledge of diabetes. The study included 247 patients with type 1 or type 2 diabetes, and demonstrated that a significantly greater proportion of patients with a basic understanding of their condition had ‘acceptable’ levels of glycaemic control (defined in the study as a fasting blood glucose (FBG) level <8 mmol/l) than those without (p = 0.03). Nurse involvement in educating patients was also shown to be valuable; 30.5% of patients who had received information from a nurse had acceptable FBG levels compared with 14.5% who had no nursedelivered information (p = 0.03). As chairman of the Global Task Force (GTF) on glycaemic control, I have been involved in a review of a survey conducted with over 2000 patients and physicians in eight countries, including the major developing nations of China and India. We identified a lack of understanding of diabetes and its management as a key barrier to the achievement of good glycaemic control. Our findings support the need for increased patient education worldwide. Like van de Sande et al., we recognise the need for a multidisciplinary approach to education, and the key role that nurses can play in educating and supporting patients. We have also identified a need to educate healthcare professionals (HCPs) on optimum strategies for achieving glycaemic control, such as regular monitoring of HbA1c levels, considered to be a more robust measure of glycaemic control than FBG. In light of these findings, the GTF, in partnership
with Novo Nordisk, is currently developing practical tools for diabetes education, which are likely to focus on the provision of educational materials, improving HCP–patient communication and guidance on the development of integrated diabetes services. The prevalence of diabetes is increasing rapidly, in both the developed world and in less-developed areas, such as the townships of South Africa. This problem is compounded by the fact that most patients are failing to meet targets for glycaemic control, as illustrated by the van de Sande et al. study, where over 70% of patients had FBG levels >8 mmol/l. Urgent steps are required on a global levels if we are to limit the impact of the diabetes pandemic. Increasing the awareness and understanding of glycaemic control is one such step, and implementation of educational programmes will improve outcomes for patients with type 2 diabetes.
Reference
[1] M. van de Sande, H. Dippenaar, G.E. Rutten, The relationship between patient education and glycaemic control in a South African township, Prim. Care Diabetes 1 (2) (2007) 87–91.
Eric Kilpatrick ∗ Department of Clinical Biochemistry, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, UK ∗ Tel.: +44 1482 607708; fax: +44 1482 607752. E-mail address: [email protected] 13 February 2008 Published on line 1 April 2008
1751-9918/$ – see front matter © 2008 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.pcd.2008.02.001
available at www.sciencedirect.com
journal homepage: http://www.intl.elsevierhealth.com/journals/pcd/
Letter to the Editor
Response to van de Sande et al. “The relationship between patient education and glycaemic control in a South African township, Prim. Care Diabetes 1 (2) (2007) 87–91”
Dear Editor, I was pleased to read the recent report by van de Sande et al., which highlights the key role of education in the global fight against diabetes and its complications [1]. Their epidemiological study, set in a South African township, evaluated the relationship between patients’ glycaemic control and their knowledge of diabetes. The study included 247 patients with type 1 or type 2 diabetes, and demonstrated that a significantly greater proportion of patients with a basic understanding of their condition had ‘acceptable’ levels of glycaemic control (defined in the study as a fasting blood glucose (FBG) level <8 mmol/l) than those without (p = 0.03). Nurse involvement in educating patients was also shown to be valuable; 30.5% of patients who had received information from a nurse had acceptable FBG levels compared with 14.5% who had no nursedelivered information (p = 0.03). As chairman of the Global Task Force (GTF) on glycaemic control, I have been involved in a review of a survey conducted with over 2000 patients and physicians in eight countries, including the major developing nations of China and India. We identified a lack of understanding of diabetes and its management as a key barrier to the achievement of good glycaemic control. Our findings support the need for increased patient education worldwide. Like van de Sande et al., we recognise the need for a multidisciplinary approach to education, and the key role that nurses can play in educating and supporting patients. We have also identified a need to educate healthcare professionals (HCPs) on optimum strategies for achieving glycaemic control, such as regular monitoring of HbA1c levels, considered to be a more robust measure of glycaemic control than FBG. In light of these findings, the GTF, in partnership
with Novo Nordisk, is currently developing practical tools for diabetes education, which are likely to focus on the provision of educational materials, improving HCP–patient communication and guidance on the development of integrated diabetes services. The prevalence of diabetes is increasing rapidly, in both the developed world and in less-developed areas, such as the townships of South Africa. This problem is compounded by the fact that most patients are failing to meet targets for glycaemic control, as illustrated by the van de Sande et al. study, where over 70% of patients had FBG levels >8 mmol/l. Urgent steps are required on a global levels if we are to limit the impact of the diabetes pandemic. Increasing the awareness and understanding of glycaemic control is one such step, and implementation of educational programmes will improve outcomes for patients with type 2 diabetes.
Reference
[1] M. van de Sande, H. Dippenaar, G.E. Rutten, The relationship between patient education and glycaemic control in a South African township, Prim. Care Diabetes 1 (2) (2007) 87–91.
Eric Kilpatrick ∗ Department of Clinical Biochemistry, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, UK ∗ Tel.: +44 1482 607708; fax: +44 1482 607752. E-mail address: [email protected] 13 February 2008 Published on line 1 April 2008
1751-9918/$ – see front matter © 2008 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.pcd.2008.02.001