A 5 dimension therapeutic patient education for type 1 diabetic patients

Objective: To assess in patients with type 1 diabetes who received training based on a multidimensional approach: The increase in knowledge relative to their disease and its treatments, their level of motivation to learn information concerning glycemic control and their willingness to apply this information to healthier behaviours, any changes in glycemic control. Methods: Fourteen diabetic patients followed a multidimensional therapeutic education program during twelve months, including a systematic reflection of the patient’s perception of his glycemia. Two questionnaires raising both knowledge and motivation issues were used in semi-structured interviews and glycated hemoglobin (HbA1c) was measured before and after the education program. Results: Diabetic patients improved their knowledge about type 1 diabetes (67.8 ± 12.6 before to 77.9 ± 9.0 after training, p < 0.01) as well as their motivation to learn and adopt healthier behaviors (56.7 ± 10.3 to 73.1 ± 7.4, p < 0.001). The improvement of the HbA1c was significant, going from 9.1 (±1.8)% to 7.9 (±1.1)% (p < 0.05), and was strongly correlated with the quality of the relationship between the patient and the caregiver/instructor and the number of training sessions. The relationship between the HbA1c and motivation appears much stronger (r2 = 0.36, p < 0.05 pre-training and 0.46, p < 0.01 post-training) than the relationship between HbA1c and knowledge about the disease (r2 = 0.28 pre-education and 0.03 post-education, NS). Conclusion: Patients who benefited from a multidimensional therapeutic education significantly improved their knowledge and their motivation to learn about their disease and eventually were more likely to take better care of themselves. The glycemia greatly improved and was strongly correlated with the patient’s motivation, the number of training sessions, and the quality of relationship between the patient and his or her caregiver/instructor