Assessment of Diabetes Continuing Medical Education

A diabetes professional education program was conducted and evaluated with 31 physicians from a rural/suburban community. Treatment guidelines were established by diabetes experts and community practitioners. To document effectiveness, medical record and survey data on 397 patients of the physicians were collected before and after the program. Each participant received a profile of their baseline performance as compared with peers as part of the educational program. A syllabus was designed to complement both the treatment guidelines and the findings from the baseline data. A telephone conference call with a diabetes consultant also occurred. A comparison between data collected before and after the program showed no significant differences in blood glucose levels or hospitalization rates. Physicians were more likely to recommend self-monitoring of blood glucose (SMBG) (7% versus 20%, P less than 0.05) and to examine their patients' feet (47% versus 73%, P less than 0.05) after the program. More patient education was available in the office (53% versus 73%). Patients using insulin were more likely to test urine for ketones (48% versus 61%, P less than 0.05) and know that decreased sensation in the feet could lead to injury (42% versus 53%, P less than 0.05). However, no improvements were noted in monitoring other complications, regulating diet, or in most aspects of patient education after the program. The results indicated the need for increased emphasis on the value of brief appropriate examinations for monitoring complications of diabetes and the need for physicians to learn techniques for counseling patients in self-management as well as to refer their patients to educational resources.