Improvement of HbA1c and stable weight loss 2 years after an outpatient treatment and teaching program for patients with type 2 diabetes without insulin therapy based on urine glucose self-monitoring

Abstract

Nicolle Müller1, Daniela Stengel2, Christof Kloos1, Michael Ristow2, Gunter Wolf1, Ulrich A Müller11University Hospital of Jena, Department of Internal Medicine III, Jena, Germany; 2Friedrich-Schiller-University Jena, Institute of Nutrition, Department of Human Nutrition, Jena, GermanyObjective: Long-term outcomes after participation in a structured diabetes treatment and teaching program (DTTP) for patients with diabetes without insulin use, primarily based upon postprandial urine glucose self-monitoring (UGSM).Methods: A total of 126 patients took part in the DTTP in a university outpatient department in 2004–2005. We re-evaluated 119 (94.4%) at baseline and at 6 months, 12 months, and 24 months. Hemoglobin A1c (HbA1c) was DCCT adjusted.Results: HbA1c decreased significantly 6 months after education from 7.33% (±1.59%) to 6.89% (±0.98%; P = 0.001 versus baseline) and was maintained for up to 12 months (7.02% ± 1.07%; P = 0.017 versus baseline) as well as up to 24 months (6.96% ± 1.06%; P = 0.005 versus baseline). Weight decreased from 92.5 kg at baseline to 90.3 kg at 24 months (P = 0.014). A total of 36.5% of patients not on insulin therapy preferred UGSM, whereas 23.5% preferred blood glucose monitoring, at 24 months. Glucose control was similar in both groups at 24 months (HbA1c UGSM 7.03 versus blood glucose monitoring 6.97%; P = 0.807).Conclusion: Participation in the DTTP resulted in long-term behavior modification. HbA1c of patients without insulin met the target 24 months after the DTTP, irrespective of the type of glucose self-monitoring.Keywords: diabetes mellitus type 2, treatment and teaching program, patient education, HbA1c, body weight