Underutilization of Diabetes Education. Experience in an Urban Teaching Hospital in the Bronx

Patient education is fundamental for diabetes management. Few studies have evaluated the “real life” frequency and impact of diabetic education. This study, conducted in a large teaching hospital in Bronx, New York, focused on a variety of diabetic educational programs offered in order to assess how often the programs are provided and their individual impact.

A convenience sample was conducted with diabetic patients (both in and outpatient) by a registered nurses or physicians. A questionnaire that included demographics, the type of education provided, as well as patients’ knowledge regarding Hemoglobin A1c (A1c), lipids, and blood pressure control.

Seventy-four adult patients were interviewed from January 2013 to December 2013. Education was provided to 37% with a similar distribution among inpatients (38%) and outpatients (33%). The majority received a one-to-one “unstructured education.” Education had no impact on knowledge and/or clinical parameter measurements. No differences were found among the A1c values between those receiving and not receiving education (A1c 8.7% vs. 8.3%), or among those hospitalized (A1c 8%) or treated as outpatients (A1c 8.4%). Similarly, LDL-cholesterol did not differ between those receiving and not receiving education (85 mg/dl vs. 89 mg/dl respectively).

The findings of this study help to identify that a gap exists in having early referral for structured diabetes education classes such as the DSME. Early diabetes education is critical in the management of the disease,and having cultural competent early diabetes education may have an impact on minorities living in large cities with large hospital institution's that offer diabetic education.