Asian Journal of Research and Reports in Endocrinology

Background and purpose:The number of diabetic patients in the Laotian population is sharply rising. Therefore, there is an increased need for innovative thinking and effective treatment of diabetes. In Laos, diabetes schools have not previously been developed and implemented as part of the treatment. The aim of the study was to implement a 12-week diabetes school for adults with type 2 diabetes and investigate the effects primarily on fasting plasma glucose (FPG). Secondarily, to evaluated effects on body weight, body mass index (BMI), waist to hip ratio (WHR), blood pressure, lipid profile, HbA1c and on the quality of life and the effects on the patient's own perception of the disease.

Materials and Methods: One hundred patients with type 2 diabetes (≥18 years) were randomized, 50 patients  participated in a newly developed 3-day a week diabetes school, teaching nutrition, physical activity and understanding of the disease as well as knowledge about the management of late diabetic complications. The 50 patients in the control group received the usual treatment. The study was not blinded. Quality of life and the patient's own perception of their disease was evaluated using the questionnaire EQ-5D and semi-structured interviews by the staff.

Results: Twelve weeks of diabetic school reduced FPG significantly (intervention: -21.0 mg / dl (SD 88.8) versus control: (+18.6 mg / dl (SD 48.8) (P = 0.02), and BMI was significantly reduced in the intervention group (-0.3681 kg / m² (SD 0.62) versus controls (+0.1042 kg / m² (SD 0.90). There were no significant effects of the intervention on HbA1c, blood pressure, WHR or lipid profile.

The focus group interviews clearly demonstrated, that most of the patients had very little insight in the consequences of their type 2 diabetes, and they do not think about the complications before these are a reality. Dietary treatment and physical activity are not established parts of the treatment of diabetes in Laos, so most health professionals know very little about the prevention of diabetic complications.

Conclusions: The 12-week diabetes school significantly reduced fasting blood glucose and BMI. Disease insight is modest in the Laotian patients with type 2 diabetes as well as in health professionals, but it was evident, that structured education of the patients have beneficial effects for the patients and probably for health professionals too.