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Therapeutic patient education and treatment intensification of diabetes and hypertension in subjects with newly diagnosed type 2 diabetes mellitus: a longitudinal study

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Abstract

Purpose

The aim of this study is to prospectively evaluate whether individual and group Therapeutic Patient Education (TPE) can reduce the need to intensify treatment of diabetes and hypertension in newly diagnosed type 2 diabetic patients.

Methods

A total of 937 patients were recruited and followed-up for 42.7 ± 21.5 months. TPE was a structured comprehensive education delivered by trained nurses: 322 patients received individual TPE (ITPE), 291 underwent group TPE (GTPE), and 324 were in Usual Care (UC). The primary endpoints were intensification of diabetes treatment and intensification of hypertension treatment.

Results

The rate of diabetes treatment intensification was 40.1% in patients receiving ITPE, 47.8% in patients undergoing GTPE, and 64.2% in patients in UC (p < 0.001). The rate of hypertension treatment intensification was 24.2% in patients following ITPE, 31.3% in patients receiving GTPE, and 41.0% in patients in UC (p < 0.001). Multivariate analysis showed that both ITPE and GTPE were associated with reduced intensification of diabetes (ITPE: HR:0.51; 95% IC:0.40–0.64; p < 0.001 – GTPE: HR:0.46; 95% IC:0.44–0.70; p < 0.001) and hypertension medication (ITPE: HR:0.45; 95% IC:0.34–0.61; p < 0.001 - GTPE: HR:0.49; 95% IC:0.38–0.65; p < 0.001). The association was independent of age, sex, BMI, HbA1c, and presence of hypertension at baseline.

Conclusions

TPE, delivered as both individual and group sessions, represents an effective tool to reduce the need to intensify treatment of both diabetes and hypertension. Therefore, it can ensure better control of diabetes and hypertension with fewer medications. This could reduce adverse effects and costs and improve quality of life and medication taking in patients with type 2 diabetes.

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Author contributions

A.C. and C.G. were the principal investigators, designed the study, wrote the article, and participated in all analyses and interpretation of data; R.P. and A.F. also performed statistical analysis; M.C., S.G., C.F., S.M. and T.M. participated in the study design, collected and checked data; A.C., L.L. and C.G. were responsible for overall supervision of the research and interpretation of data. All investigators have contributed to the writing, reviewing and editing the paper and have approved the final version.

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Authors and Affiliations

  1. Diabetes and endocrine-metabolic Diseases Unit, Istituto Clinico Beato Matteo, Gruppo Ospedaliero San Donato, Vigevano, Italy

    Adriana Coppola, Maritza Chuquitaype, Selene Guglielmo & Carmine Gazzaruso

  2. Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Catanzaro, Italy

    Roberta Pujia, Samantha Maurotti & Tiziana Montalcini

  3. Department of Endocrinology, IRCCS Multimedica, Milan, Italy

    Anna Ferrulli & Livio Luzi

  4. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy

    Anna Ferrulli, Livio Luzi & Carmine Gazzaruso

  5. CIRMC, University of Pavia, Pavia, Italy

    Colomba Falcone

  6. Cardiology Unit, Istituto di Cura Città di Pavia, Gruppo Ospedaliero San Donato, Pavia, Italy

    Colomba Falcone

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  1. Adriana Coppola
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  2. Maritza Chuquitaype
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  8. Tiziana Montalcini
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  9. Livio Luzi
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Correspondence to Adriana Coppola.

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The study was carried out according to the ethical standards of the institutional research committee and with the 1964 Helsinki declaration. The local Ethics Committee has approved the protocol. Informed consent was obtained from all individual participants included in the study.

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Coppola, A., Chuquitaype, M., Guglielmo, S. et al. Therapeutic patient education and treatment intensification of diabetes and hypertension in subjects with newly diagnosed type 2 diabetes mellitus: a longitudinal study. Endocrine (2024). https://doi.org/10.1007/s12020-024-03839-8

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