Diabetes education of patients and their entourage: out-of-hospital national study (EDUCATED 2)

Aims To determine the contributing factors in the successful diabetes education of patients and their entourage. Methods Prospective observational study conducted in a pre-hospital setting by 17 emergency services across France (September 2009-January 2011) included all insulin- treated patients (>= 18 years) provided that at least one family member was present on scene. Data were collected from patients and their entourage: (1) personal details including language proficiency and educational attainment, (2) treatments, (3) diabetes-related data (log sheets, glucose meter, glucagon, glycated hemoglobin, prior hypoglycemic episodes); (4) care by diabetologist, general practitioner and/or visiting nurse. The main end points were ability to measure capillary blood sugar (patient) and awareness of hypoglycemia symptoms and ability to administer glucagon (entourage). Results Overall, 561 patients and 736 family members were included; 343 patients (61%) were experiencing a hypoglycemic episode (< 2.5 mmol/L). A total of 141 (75%) patients and 343 (50%) family members could measure capillary blood sugar. They could name a median of 2 [ 0-3%] hypoglycemia symptoms although 217 (39%) patients and 262 (39%) family members could name nosymptom. Few patients (33%) had glucagon available. In multivariate analyses, the main factor associated with better patient education was care by a diabetologist. Lack of an educational qualification and visits by a nurse were associated with poor patient education, and French mother tongue and care by a diabetologist with better education of the entourage. Conclusions In France, diabetic patients and their entourage are inadequately educated. Their education benefits most from care by a diabetologist.