Evaluation of a Teaching and Treatment Program in Over 4,000 Type 2 Diabetic Patients After Introduction of Reimbursement Policy for Physicians

Patient education in diabetes has become an integral part of diabetes management (1–3). Systematic reviews report the best results in terms of improved metabolic control, weight loss, and diabetes-related knowledge in cases where mainly nurses provide patient education combined with structured and regular patient review. Therefore, patient education is recommended as a necessary component in promoting good diabetes control (4,5). In 2000, the Styrian Diabetes Type 2 Education Project was implemented across the Austrian province of Styria. Until then, no formal implementation or reimbursement of educational efforts had been provided in the Austrian health care system. The primary objective of the project was to provide free access to a structured diabetes teaching and treatment program (DTTP) at the primary health care level throughout the province to patients with type 2 diabetes who are not using insulin for glycemic control. Here, we report its overall acceptance and effectiveness 4 years after its systematic implementation. The Styrian Diabetes Type 2 Education Project is a combined intervention consisting of a structured DTTP and a special training for the educating staff. The DTTP is a 16-h course, conducted at the primary health care level. It is well evaluated and transferable (6–10). The program covers nine education areas: basic diabetes information, self-monitoring, medication and hypoglycemia, diet, foot care, physical activity, sick day rules, and late complications. Training of the educators (physicians and diabetes educators) focuses on …