Effect of Diabetes Education Program on Type 2 Diabetic Patients in Tulkarm Directorate of Health

Discussion Committee: 
Dr. Haleama Al Sabbah /supervisor
Dr. Sumaya Sayej / External Examiner
Dr. Samar Ghazal / Internal Examiner
Dr. Haleama Al Sabbah
Osama Abdulkareem Abdurrahman Rashed
Background: In the Palestinian community, lifestyle changes, rapid urbanization and socioeconomic development, stress, smoking, changes in food habits may increase the risk of non-communicable diseases especially diabetes mellitus. Diabetic complications can be prevented if the glycaemic status of diabetic patients is maintained within a nearly normal range. Therefore, patient education is critical in controlling blood glucose levels within the normal range. Objective: This study aimed at measuring the effect of diabetes educational program for type 2 diabetic patients attending the Diabetic clinic in Tulkarm Directorate of Health. Methods: A quasi-experimental study with pre and post-test was carried out through the diabetic clinic in Tulkarm Directorate of Health based on educational intervention program. In total, a convenient sample of 215 patients were attended a group-based educational intervention session about diabetes which is conducted by the researcher .This session is a four hours education program. It was presented once at the sports clubs and different civil society organizations and sometimes at the patient’s houses according to a previous appointment. The program includes definition of diabetes mellitus, symptoms, risk factors, types, treatment and complications and main aspects of self-care of the disease (foot care, eye care, and blood glucose monitoring), main aspects of dietary management, weight reduction, blood pressure, smoking, periodic investigations, home monitoring and importance of physical activity) for diabetic patients. Knowledge evaluation questionnaire were evaluated pre and post study. Anthropometric measurements (WT, BMI, WC) and lab tests (FBG, HbA1c, Chol, and TG) were measured at the beginning and at the end of the study. Significance of the results was assessed by paired t- test at 95% confidence interval using SPSS version 16. Result: The participant’s mean age was 51.07, ranged between 31 and 70 years. Of the total number of participants (215), 41.4 % were males and 58.6% were females. A significance in weight reduction (p =0.000) was found, the mean weight and standard deviation before intervention was 80.81kg ± 14.95 (82.6 for males and 79.5 for females) had decreased to 78.9±14.33 (81.1 for males and 77.3 for females) after educational intervention program, accordingly, BMI was also decreased significantly (p =0.000) after educational intervention. While, waist circumferences decreased significantly (p=0.036.) after intervention from 96.36 ± 12.34 to 95.51 ± 11.25. On the other hand, a significant decrease were observed in FBS after educational intervention (p =0.049), the mean fasting blood sugar was 188.65±71.45 before educational intervention decreased to 177.7±66.11 after the educational intervention. Moreover, a significant decrease in glycosylated haemoglobin after educational intervention (p = 0.000) were reported, the mean glycosylated haemoglobin was 8.57± 1.21 before educational intervention have decreased significantly to 7.95±1.42 after educational intervention. In addition, a significant decrease was observed in cholesterol level after educational intervention (p=0.000).The mean value of cholesterol before educational intervention 183.27± 37.74 decreased to 169.57±34.23 after educational intervention .Whilst, a slight significant decrease in triglycerides level were reported after conducting educational intervention (p=0.025), the mean triglycerides value decreased after educational intervention from 209.85±171.04 to 183.28±152.4. Moreover, a significant increase in knowledge evaluation test scores were shown after educational intervention (p = 0.000). The mean score of knowledge questionnaire before educational intervention was 60.6±20.65 increased to 78.1±13.4 after conducting educational intervention Conclusion: The results from this short educational intervention program on Type 2 diabetic patients in Diabetic clinic in Tulkarm Health Directorate indicates that lifestyle changes involving dietary, exercise and diabetes self-management being effective in significant decrease in weight, FBS,GhA1c ,Chol and TG and effective in improving patient’s knowledge. Recommendations: Diabetes education is a cornerstone in the management and care of diabetes and should be an integral part of health planning involving patient’s family, diabetes care team, community and decision makers in the education process.
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