Effect of re-coaching on self-injection of insulin in older diabetic patients - Impact of cognitive impairment.

Abstract Aims We investigated the effect of re-coaching on self-injection of insulin and impact of cognitive function in 100 older diabetic patients. Methods We examined patients on a variety of skills and knowledge regarding self-injection of insulin and evaluated the effect of re-coaching the patients after 3 months and 4 years. We also investigated the influence of cognitive impairment (CI) on coaching. Results Skills scores for self-injection of insulin and HbA1c improved significantly 3 months after re-coaching. In 51 patients followed-up for 4 years, skills scores were maintained during the 4 years, while knowledge scores improved after 3 months but then returned to the baseline level. In the group of patients with CI as determined by the Mini-Mental Status Examination, skills scores were similar to those in the group without CI, while knowledge scores were significantly lower as compared with those in the group without CI at any time point. Skills scores were maintained during the 4 years regardless of CI. Conclusion The present study showed that re-coaching in skills for self-injection of insulin was effective in improving and maintaining insulin treatment in older diabetic patients, even if patients had CI.