Diabetes Self-Management Education’s Effect on Patients’ Glycated Haemoglobin and Foot Self-Care at Two Hospitals in Ebonyi State, Nigeria

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) can worsen foot injuries. This study compared the effects of Face to Face (F2F) and Blended Diabetes Self-Management Education (BDSME) on Glycated Haemoglobin (HbA1c) and foot self-care among T2DM patients in two tertiary hospitals in Ebonyi State, Nigeria.

Methods: A two-group pre and post quasi-experimental design was adopted for the study. Using cluster random sampling, 178 participants were selected out of 1,187 registered diabetic patients and enrolled into two groups (89 in BSDME and 89 in F2F). The F2F group received 2-hour in-person training sessions every three weeks based on the American Association of Diabetes Educators’ seven-process model (AADE7) curriculum. The BDSME group received the in person sessions and three take home online videos on diabetes management. Data were collected using a demographic survey, electronic HbA1c analyzer, and the Diabetic Foot Disease and Foot Care Questionnaire (r = 0.88). Descriptive statistics, chi squared and independent sample t-test were used for data analyses at p < 0.05.

Results: At baseline, the BDSME group had lower HbA1c (p = 0.03) but inadequate foot care (p = 0.001) than the F2F group. At six months follow-up, the BDSME group’s HbA1c remained lower (p = 0.001), and the foot self-care became significantly better (p = <0.001) than in the F2F group.

Conclusion: In comparison to F2F, BDSME performed better at sustaining long-term adherence to diabetes foot self-care. Nursing care providers should consider BDSME for improving diabetes foot self-care.