Education program for non-insulin-dependent (type 2) diabetes mellitus patients, aged 40-45, in Yerevan and evaluation of the program

Abstract

Diabetes education programs are widely implemented in many countries and have scientific evidence of their success. The objective of this paper is to propose implementation and evaluation plan of an education program for patients with Diabetes Mellitus (DM) Type-2, aged 40-45, in Yerevan. DM is a great public health problem in Armenia. It is considered as a serious public health problem, posing a significant burden in mortality, morbidity and cost. Deaths from Diabetes Mellitus (DM) are mostly due to its complications. The prevalence of DM among adults and teenagers was 1237.2 per 100,000 population and the death rate was 31.78 per 100,000 population in Armenia in 1998. The absolute registered number of diabetic patients was 34,761. An increase is registered in death rates during the last 10 years, which grew from 11.72 in 1988 to 31.78 per 100,000 population in 1998; incidence rates grew from 65.2 in 1994 to 86.5 per 100,000 population in 1998. The increasing burden of DM and its complications is alarming. But much of this burden can be prevented with behavioral changes, education for self- management, self-control of diabetes. All of the above mentioned prove the existence of an urgent need for diabetes prevention program s in Armenia. Self-control and monitoring of blood glucoseare the key elements in this education program, stressing low caloric intake, control of body weight, and control of blood glucose by physical activity. The program emphasizes prevention by behavioral and knowledge changes. This education program aims: 1) to prevent such complications of diabetes, as diabetic retinopathy, neuropathy, nephropathy and ischemic heart disease; 2). to reduce mortality and disability from diabetic complications; 3) to gain additional years of life; 4) to improve the quality of life among diabetic patients; 5) reduce expenditures for medical care. Four endocrinologists will conduct this program for 272 patients. Ten lessons will be conducted with 10-11 patients in each group. Quasi-Experimental design was chosen for program evaluation. It involves an intervention (IG) and control (CG)groups, both given a pre-test and a post-test, but in which the CP and IP do not have pre-experimental sampling equivalence. Simple random sampling will be used to select each sample group. The sample frame for each group will be the list of diabetic patients type- 2, aged 40-45, living in Yerevan, having a history of registered DM equal or less than 12 months, registered in that polyclinic. Each sample will be drawn randomly, using random start. Randomly will be drawn numbers between last and first ones on the list, sampling without replacement, using random digit tables. The total budget for this proposal will be $ 38,752.21.