Efficacy of Diabetes Education in Adults With Diabetes Mellitus Type 2 in Primary Care: A Systematic Review.

PURPOSE: To analyze the effect of different diabetes education methods on metabolic control, body mass index (BMI), and blood pressure. DESIGN: A systematic review was carried out. DATA SOURCES: PubMed, Medline, Embase, Cochrane, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), CUIDEN, Ibecs, and Scopus databases were consulted. The search was done in May 2018. Studies included controlled clinical trials on diabetes education in primary care that were published in English and Spanish during the years 2011 to 2018. RESULTS: The post-intervention results were as follows: glycosylated hemoglobin concentration (HbA1c) ranged between -1.6% (individual education [IE]) and + 0.05% (mixed education [ME]). The values of BMI varied from -0.7% (group education [GE]) to -0.3% (GE). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) fluctuated. SBP varied from -8.5 mmHg (GE) to +2.9 mmHg (GE); DBP varied from -3.1 mmHg (GE) to -0.9 mmHg (GE). Total cholesterol ranged from -15.9/dL (GE) to +2 mg/dL (GE). LDL cholesterol ranged from -18.3 mg/dL (GE) to -7 mg/dL (ME). HDL cholesterol ranged from +0.8 mg/dL (IE) to +8.12 mg/dL (GE). Triglycerides varied from -21.1 mg/dL (GE) to +11.0 (GE). CONCLUSIONS: The most profound decrease in HbA1c was achieved using individual education. However, to decrease BMI, SBP, DBP, total cholesterol, LDL cholesterol, and triglycerides, group education was the most effective intervention. CLINICAL RELEVANCE: To obtain good metabolic control, it is necessary to address both clinical and psychological aspects, including modifying nutritional and dietary habits, monitoring medication, increasing knowledge of diabetes, and combining theoretical content with physical exercise programs. Reinforcement strategies are very important to achieve the objectives of educational programs.

[Who is the user of socio-health interventions and what are their needs?]. / ¿Quién es el receptor de intervenciones sociosanitarias y cuáles son sus necesidades?

Socio-health interventions include performance and care intended to attend to the needs of people who have suffered a decrease in their personal autonomy because of their age, illness or disability. Oriented towards achieving an improvement in the quality of life of people in that situation, they try to meet the requirements of people in an integrated way. To intervene in those situations involves providing technical aids and environmental, custom and social changes as well as personal care needed to improve their quality of life and enhance their skills and well-being. Scientific advances and demographic and social changes have determined a change in the profile of socio-health interventions' receivers, highlighting longevity, chronicity of processes and aging of the informal caregiver. The aim of this work is to characterize the person receiving the social-health interventions and to reflect on what their needs are. To do this we have conducted a biomedical studies' review through literature searches at ScienceDirect as well as a review of national institutional documentation related to people in dependent situations and their family caregivers. People who need socio-health help establish a heterogeneous population in respect of their needs. Both the person with disabilities and their informal caregiver need to be considered as an object of interest and attention.