Education, Counseling Associated with Improved Clinical Outcomes in Type 2 Diabetes

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Wayne Kuznar

San Diego, CA—Patients with type 2 diabetes who use education and counseling services offered by their managed care plan have better glycemic control and lower diabetes health-related costs. However, few managed care patients with type 2 diabetes use these services, investigators from Premier Research Services, Charlotte, NC, found in a study presented at the 2011 Scientific Sessions of the American Diabetes Association.

The researchers examined medical and pharmacy data from the Premier-i3 Continuum of Care database, which links a large outpatient research database with a large hospital database. Included in this analysis were 26,790 adult patients with type 2 diabetes. Of these, 2490 (9.3%) received 1 or more education and counseling interventions; 90.7% received no education and counseling.

Diabetes education (73.2%) and nutrition/diet counseling (21.0%) were the most common forms of education and counseling intervention.

After 12 months of follow-up, the mean hemoglobin (Hb)A1c level was 6.7% among those in the education/counseling group, which was significantly lower than the 7.5% in the control group (no education/counseling service used).

Patients who used education/counseling had a 4-fold greater likelihood of achieving glycemic control than the control group. An HbA1c level <7.0% was achieved in 71.9% of patients who received education/counseling compared with 51.3% in the control group.

Education/counseling had no significant effect on the incidence of hypoglycemia; slightly more than 1.0% in each group had a hypoglycemic event.

A matched cohort (based on demographic and baseline factors) of 1890 patients was also evaluated. In this analysis, 12-month HbA1c values were again lower in the group that received education/counseling, and the odds for achieving glycemic control were still 4 times greater in this group versus the control group. In the education/counseling group, 71.0% of patients achieved HbA1c levels <7.0% compared with 48.6% in the group that did not receive education/counseling. As in the unmatched cohort, the percentage of hypoglycemic events was similar in the 2 groups.

In the unmatched cohort, the total healthcare costs were similar between the 2 groups at 12 months: $22,531 in the education/counseling group and $22,121 in the control group. Patients in the education/counseling group, however, had a 43% decrease in diabetes-related costs compared with the control group ($5313 vs $11,448).

In the matched cohort, total healthcare costs were higher in the education/counseling group versus the control group ($24,747 vs $18,378), but diabetes-related charges were again lower in the education/counseling group versus the control group ($6795 vs $9130).

Patients who received education/counseling were more likely to be women and to have lower levels of comorbidity compared with individuals who did not receive such support.

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Last modified: February 14, 2019
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