That it organization was accepted on the “Therapeutic Degree off Patients suffering from type 2 diabetes” program in 2011

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That it organization was accepted on the “Therapeutic Degree off Patients suffering from type 2 diabetes” program in 2011

A curative education network as the laid out because of the Post L 6321-hands down the Societal Fitness Password was developed in the 2003 inside the a south city of the brand new company regarding Aisne ( French minister for solidarity and you will wellness, 2016 ; Legifrance, 2016 ). It absolutely was made up of certain people, several care about-employed: general therapists, nurses, podiatrists, pharmacists, doctors, sporting events instructors, biologists, psychologists, art practitioners, secretaries, and you may patient advocates. They has worked in partnership with the two medical facilities in the region together with into local government in a reaction to the latest requires of inhabitants. He’s got supported more than one thousand patients for the past 15 years, with the objective away from decreasing the Bmi and you may HbA1c regarding acting patients. Which have hindsight, what was new perception of this therapeutic diligent training network on the the region? A portion of the objective of one’s studies would be to assess the effects of your circle on the Bmi and you can HbA1c from customers with diabetes tracked of . The fresh additional purpose were to dictate the brand new affect the patients’ adjusted physical exercise and you may therapeutic knowledge instruction starred for the several clinic-physiological parameters chosen.


A keen observational, quantitative, retrospective, and you may monocentric study was held. The content range concerned just how many healing diligent degree instructions and you will modified activities as well as the evolution regarding HbA1c and Body mass index regarding patients which have diabetes once its monitoring in the system between 2013 and you may 2018. The latest local area included in the new network is 30 miles that have a prevalence out of all forms of diabetes within 4.9% from inside the 2007 ( France Television, 2014 ). A demand was created on network’s board regarding administrators to help you search their agreement to carry out the research. Recommendations is actually accessible to patients via the network’s newsletter. The data range period live away from , equal to brand new computerization of the community by Logireso® software. Previous study was not accessible to the fresh specialist. Brand new addition requirements on analysis have been: an imbalanced diabetic issues (>7%) and you can at least go after-upwards out of six months about system enabling around three HbA1c measurements that have at least gap regarding three months anywhere between for every data. Which managed to get you’ll to retain logical and you will physiological size of HbA1c and you may Bmi in the very beginning of the treatment, at the mid-title at the end of the fresh new suggested keeping track of.

People was in fact directed toward system from the its general practitioner to have unbalanced type 2 diabetes (HbA1c above the address range into patient’s decades and you may comorbidities) and frequent comorbidities on the inactive existence or being obese. Many different informations (ages, intercourse, duration of keeping track of, number of healing knowledge training and modified exercises did by the the individual, and you can HbA1c and Body mass index specifications) had been accumulated. The fresh destroyed recommendations throughout the system document was complete because of the getting in touch with both this new patient’s likely to physician or the city’s clinical biology laboratories. The latest entry regarding anonymized investigation was over with the a be noticed® spreadsheet.

Mathematical research are did having fun with SPSS® application. The brand new decimal studies was entered toward Student’s t sample getting paired products (clinic-physiological dimensions). A good linear regression attempt, having formula of the linear regression coefficient Roentgen? try performed to assess the potency of correlation between the assessed parameters. The variety of philosophy is laid out becoming anywhere between zero and one to. The brand new better the effect involved one, the greater amount of legitimate the regression. The importance height try place during the 0.05.


The study included 282 patients with an age range from 41 to 84 over a five-year period. Only 59 patients met the inclusion criteria (20.9%). Among the patients not included, 69 did not have sufficient monitoring to be able to analyze an effect on the clinic-biological measures (less six month) or had type 1 diabetes, 32 patients refused monitoring by the network after a first meeting, and 123 had incomplete data in their file in HbA1C or BMI. Among the patients included, 59% of them were women, and the average age was 64 years old. The mean duration of monitoring was 23.8 months [6, 53] with a median of 21 months. The patients had completed an average of ten sessions of adapted physical activities [0, 93] and sixteen therapeutic patient education sessions [0, 73]. In regard to the variation in the BMI of the population studied, the average BMI at the start of the treatment course was 34.1 kg/m?, at the middle of the monitoring 33.2 kg/m?, and at the end of the monitoring 32.9 kg/m?. Throughout the monitoring, the BMI dropped significantly at the mid-term –0.94 kg/m? (p < 0.001) and –1.65 kg/m? (p < 0.001) at the end of the monitoring period. Likewise, the mean HbA1c at entry was 7.5%, at mid-course 6.9%, and at end of follow-up 6.6%. The decrease in absolute HbA1c at mid-term was –0.61% (p < 0.001) and –0.86% (p < 0.001) at the end of the monitoring period. The decreases observed in the two analyses were more marked during the first half of the monitoring period. This decrease was greater when the initial values were high. Regarding the tests on the absolute values, no link was found between the decrease in BMI and the number of sessions of adapted physical activities (p = 0.74) or with the number of therapeutic patient education sessions (p = 0.66), nor between HbA1c and adapted physical activity (p = 0.63) or the number of therapeutic patient education sessions (p = 0.73). However, the analysis of the impact of the participation of patients in the network on the absolute value of HbA1c found a very marked downward curve (p < 0.001) with a regression coefficient, R? = 0.7, confirmed by the distribution of points very close to the line of regression (Figure 1 ).

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