Abstract


Achieving goals in type 1 diabetes (T1D) remains a challenge dependent on the adherence to techniques and attitudes necessary to reach and keep good control. Emotional burden and direct and indirect costs can also be enormous. We analysed the results in HbA1c and the achievement of treatment goals of an empowerment group for patients with T1D (AmigO Tipo 1 group).

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Achieving goals in type 1 diabetes (T1D) remains a challenge dependent on the adherence to techniques and attitudes necessary to reach and keep good control. Emotional burden and direct and indirect costs can also be enormous. We analysed the results in HbA1c and the achievement of treatment goals of an empowerment group for patients with T1D (AmigO Tipo 1 group).

Patients of two private services, one in Endocrinology and one in Pediatric Endocrinology, in Dourados (MS) - a town of 200,000 inhabitants in Brazil and the reference center in health services for almost 1,000,000 people - were invited to take part in a group to participate of empowerment activities discussing concepts, diabetes education and motivational experiences. Patients were selected based on motivation for good control and interest in diabetes self-management. For data analysis, those with less than two HbA1c measurements during the study period were excluded.

There were 7 meetings between April 2015 and April 2016. 41 patients with T1D aged 1 to 63 years (average 19.6) and their family members were invited. 25 patients on average attended each meeting with their families, resulting in more than 60 person/meeting. We excluded data from patients in honeymoon phase and from one patient who had a ketoacidosisis during the period. For analysis patients were separated in two groups according to the number of meetings attended. Those who attended at least 3 of the 7 meetings (n = 26) had lower HbA1c levels at the end of the period, what did not occur with those who attended only 1 or 2 meetings (8.3±1,3% to 7.5±1.4% vs. 8.8±1.8% to 9.2±2.2%, p<0.013). The number of adherent patients with HbA1c ≥ 8.5% dropped by half (46%,12/26 before the meetings vs. 23%, 6/26 after, p<0.0017). Between those patients, the number of participants with HbA1c < 7% increased from 5 to 13/26 (p<0.0085). Financial costs of the project were of USD 7/patient/meeting.

We concluded that the empowerment group had efficacy in achieving better results in the treatment of patients with T1D, achieving significantly better HbA1c levels and much greater number of patients under good glycemic control. Patients and their family members are now much more adapted to their routine needs. In our days, optimizing resources and finding intelligent, creative, acceptable and low-cost alternatives to achieve goals in diabetes treatment is of the utmost importance.

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