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Diabetes Mellitus, Type 1 > Patient Education Author: Maureen D. Passaro, MD; Robert E. Ratner, MD
Editorial changes - 2010-02-17
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Rationale:

  • Understanding the facets of diabetes self-management can prevent diabetic ketoacidosis, unnecessary hospitalizations, and absence from work or school as well as future complications.

Evidence:

  • Intensive therapy in patients with diabetes is associated with a decrease in microvascular complications; however, there is a threefold increase in the risk of hypoglycemia (25).
  • The Diabetes Control and Complication Trial (an NIH-sponsored multicenter trial) showed that with aggressive education and intensive management, HbA1c could be decreased to less than 7%; however, this intensive control is associated with an increased risk of hypoglycemia (25; 90).
  • Frequent self-monitoring of blood glucose and instruction on insulin adjustment, diet, and exercise are essential for improving glycemic control in patients with type 1 diabetes (135; 136; 137).
  • A randomized controlled trial found that an intervention designed to reduce risk factors for lower extremity amputations had a positive effect on patient self-foot-care (138).
  • One study showed that intensive diabetes education with insulin adjustment decreased the incidence of ketoacidosis and hospitalization (139).

Comments:

  • None.
FAQs
Abd Tahrani, MD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Maureen D. Passaro, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Robert E. Ratner, MD, is a consultant for Amylin Pharmaceuticals, AstraZeneca, GlaxoSmithKline, Lifescan, Inc., NovoNordisk, Sanofi-Aventis, Takeda, owns stocks in Merck, Johnson & Johnson, Abbott, received grants from Amylin, AstraZeneca, Bayhill Therapeutics, Boehringer Ingelheim, Conjuchem, Inc., Eil Lilly, GlaxoSmithKline, Merck, NovoNordisk, Pfizer, Sanofi-Aventis, Takeda.
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for continuing medical education grand rounds and lectures given.

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