| Learning Objective #1: Understand the importance of educating patients with diabetes mellitus and hypertension to increase their self-care abilities | |||
| Learning Objective #2: Gain knowledge about the effectiveness of counselling diabetes patients |
Introduction: The prevalence of Diabetes mellitus of adults in Germany is estimated between 7%-8%. Approximately 30%-40% of them will develop arterial hypertension during their illness. Lowering high blood pressure is the most important measure for reducing micro- and macro-vascular complications. Successful therapy requires patients continued active involvement in their therapy. There is evidence for short term effectiveness of structured patient-education. Long term effects as well as effectiveness of implementation in clinical practice on a larger scale have not been studied sufficiently. Objective: The aim of this long-term-evaluation was to investigate whether a hypertension-education-program implemented on a large scale in Germany enables patients to participate actively in reducing their high blood pressure. Design: Multi-centred prospective panel-study with 5 data-collection points over a period of 3 years. Setting/ Participants (after 2 years): 33 Diabetes care centres with 311 diabetics (24% type-1 and 76% type-2). Instruments: Standardized questionnaires to assess patient’s blood-pressure taking and eating habits, their blood-pressure, HBA1c-and lipid levels, body weight and knowledge about disease and treatment. Results: The proportion of patients who regularly took their blood-pressure increased about 32%-points and two years after the education programme blood-pressure values are lower than two years before (systolic p<0.05, diastolic p<0.001). 76,9% of the participants reported reduced sodium-chloride in their nutrition. Two years after the education programme knowledge is still higher than before training (p<0.001). Conclusions: Results demonstrate that a hypertension-education- program can be effectively implemented on a large scale in clinical practice enabling diabetics to actively monitor and reduce their bloodpressure. The UKPDS-study findings demonstrated that lowering blood pressure to a mean of 144/82mmHg reduced the risk for diabetes-related mortality up to 32% compared with the group of diabetics with a mean blood-pressure of 154/87mmHg.Results also demonstrate that positive effects can be maintained over a 2 year period.
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