Effects of a revision program on the control of type 2 diabetics followed at the primary care level. Diabetes First program

BACKGROUND AND OBJECTIVE: To analyze the evolution of the glycosylated hemoglobin and other parameters after performing a control program and follow-up by nurses to improve the control of the patients with type 2 diabetes mellitus (Diabetes First). PATIENTS AND METHOD: Intervention study in type 2 diabetes mellitus patients from Murcia. The inclusion criterium was to be a type 2 diabetes mellitus patient badly controlled on diabetes parameters (glycosylated haemoglobin > or = 7%). We included 831 patients from 8 primary care centers. The program consisted of three visits (first one, after three months and after six months), where the patients received diabetic education. RESULTS: The mean initial glycosylated haemoglobin value was 8.1% +/- 1.3%, after 3 months it decreased to 7.5% +/- 1.1%, and after 6 months from the first visit its value was 7.5% +/- 2.6%. There was a statistically significant (p < 0.001) difference between the initial glycosylated haemoglobin and the values three months later. There was not such a difference between the second and third visit. Total and low-density liporpotein cholesterol decreased significantly after 3 months (p < 0.05). High-density lipoprotein cholesterol and triglycerides showed no difference. Systolic and diastolic blood pressure significantly decreased after three months (p < 0.0001 and p < 0.005). CONCLUSIONS: A simple nursing intervention program performed in primary care centers has a very positive impact on the control and treatment of patients with type 2 diabetes mellitus.