Assessment of glycemic control in patients with type 2 diabetes mellitus and obesity with different cognitive statuses based on the results of self-management education

Type 2 diabetes mellitus (T2DM) is one of the leading non-infectious diseases worldwide, increasing the risk of deve­loping cardiovascular and microvascular complications. Successful mana­gement of the disease largely depends on patient involvement, their level of knowledge and self-management skills. People with cognitive impairment, which can negatively affect the course of diabetes, require special attention. The purpose of the study was to evaluate the results of a one-year follow-up of the effectiveness of diabetes self-management education in patients with T2DM and obesity with different cognitive statuses. The study included 140 people with T2DM and obesity aged 25 to 60 years. Depen­ding on cognitive status and participation in the training program, they were divided into four subgroups: standard treatment with or without self-management education, with or without cognitive impairment. The education program included 9 group sessions followed by a 12-month observation period. After 12 months, patients who underwent self-management education demonstrated a significant reduction in fasting blood glucose, glycated hemoglobin (HbA1c), total cholesterol, body mass index, waist circumference, as well as systolic and partially diastolic blood pressure (p < 0.05–0.001). The Michigan Diabetes Knowledge Tool scores increased by 20–29 % (p < 0.001) in the subgroups with self-management education. A strong positive correlation was found between body mass index and HbA1c (ρ = 0.95; p < 0.000001), and a significant inverse correlation — between diabetes knowledge and HbA1c (r = –0.79; p < 0.001). Self-management education significantly improves clinical and metabolic parameters and increases knowledge in patients with T2DM, regardless of cognitive status. Diabetes school programs should be considered an essential component of care to achieve optimal disease control and prevent complications.