Diabetes Metab J.  2016 Dec;40(6):447-453. 10.4093/dmj.2016.40.6.447.

Factors Associated with Participation in Diabetes Education: The Korea National Health and Nutrition Examination Survey 2007 to 2009

Affiliations
  • 1Department of Internal Medicine, Cardiovascular and Metabolic Disease Center, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea. djkim@paik.ac.kr

Abstract

BACKGROUND
A recent study revealed that the participation rate in diabetes education among diabetic patients was only about 50% in Korea. We investigated the factors associated with participation in diabetes education.
METHODS
The study included 1,255 patients (≥19 years old) diagnosed with diabetes drawn from the total Korea National Health and Nutrition Examination Survey 2007 to 2009 population comprising 30,705 individuals. We compared age, sex, and age- and sex-adjusted clinical characteristics in patients who had received diabetes education versus those who had not.
RESULTS
Of the 1,255 patients, 19.8% (n=248) had received diabetes education. Patients in the group who received diabetes education were younger, diagnosed at an earlier age, had a longer diabetes duration and were more likely to be using insulin therapy compared with the group who did not receive diabetes education (P<0.001). The group who received diabetes education included fewer manual workers (P<0.001) but more college graduates (P=0.004) compared with the group who did not receive diabetes education. Logistic regression analysis revealed that longer diabetes duration increased the likelihood of receiving diabetes education (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01 to 1.06; P=0.004). Junior high school (OR, 0.47; 95% CI, 0.24 to 0.91; P=0.026) and elementary school education levels (OR, 0.34; 95% CI, 0.17 to 0.65; P=0.001) versus college graduation were inversely correlated with participation in diabetes self-management education. Non-insulin therapy reduced the likelihood of receiving diabetes education (OR, 0.37; 95% CI, 0.21 to 0.64; P<0.001).
CONCLUSION
Longer diabetes duration, insulin therapy, and higher education level were positively associated with the completion of diabetes education.

Keyword

Diabetes; Education; Education level; Korea; Participation

MeSH Terms

Education*
Humans
Insulin
Korea*
Logistic Models
Nutrition Surveys*
Self Care
Insulin

Cited by  2 articles

Sociodemographic Factors Associated with Participation in Diabetes Education among Community-Dwelling Adults with Diabetes
Young-Hoon Lee
Yonsei Med J. 2020;61(2):169-178.    doi: 10.3349/ymj.2020.61.2.169.

Management Status of Patients with Type 2 Diabetes Mellitus at General Hospitals in Korea: A 5-Year Follow-Up Study
Jin Hee Jung, Jung Hwa Lee, Hyang Mi Jang, Young Na, Hee Sun Choi, Yeon Hee Lee, Yang Gyo Kang, Na Rae Kim, Jeong Rim Lee, Bok Rye Song, Kang Hee Sim
J Korean Diabetes. 2022;23(1):64-75.    doi: 10.4093/jkd.2022.23.1.64.


Reference

1. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011; 94:311–321.
2. Bos-Touwen I, Schuurmans M, Monninkhof EM, Korpershoek Y, Spruit-Bentvelzen L, Ertugrul-van der Graaf I, de Wit N, Trappenburg J. Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: a cross-sectional survey study. PLoS One. 2015; 10:e0126400.
3. Cho NH. Diabetes burden and prevention in Korea and the Western Pacific Region. Diabetes Res Clin Pract. 2014; 106:Suppl 2. S282–S287.
4. Statistics Korea. Cause of death statistics 2012. updated 2013 Sep 25. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&aSeq=308559.
5. Norris SL, Lau J, Smith SJ, Schmid CH, Engelgau MM. Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care. 2002; 25:1159–1171.
6. Gary TL, Genkinger JM, Guallar E, Peyrot M, Brancati FL. Meta-analysis of randomized educational and behavioral interventions in type 2 diabetes. Diabetes Educ. 2003; 29:488–501.
7. National Standards for Diabetes Self-Management Education Programs. Task Force to Revise the National Standards. The American Diabetes Association. Diabetes Educ. 1995; 21:189–190.
8. Steinsbekk A, Rygg LO, Lisulo M, Rise MB, Fretheim A. Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis. BMC Health Serv Res. 2012; 12:213.
9. Cooke D, Bond R, Lawton J, Rankin D, Heller S, Clark M, Speight J. U.K. NIHR DAFNE Study Group. Structured type 1 diabetes education delivered within routine care: impact on glycemic control and diabetes-specific quality of life. Diabetes Care. 2013; 36:270–272.
10. Standards of medical care for patients with diabetes mellitus. American Diabetes Association. Diabetes Care. 1994; 17:616–623.
11. Jung JH, Lee JH, Noh JW, Park JE, Kim HS, Yoo JW, Song BR, Lee JR, Hong MH, Jang HM, Na Y, Lee HJ, Lee JM, Kang YG, Kim SY, Sim KH. Current status of management in type 2 diabetes mellitus at general hospitals in South Korea. Diabetes Metab J. 2015; 39:307–315.
12. Ardena GJ, Paz-Pacheco E, Jimeno CA, Lantion-Ang FL, Paterno E, Juban N. Knowledge, attitudes and practices of persons with type 2 diabetes in a rural community: phase I of the community-based diabetes self-management education (DSME) program in San Juan, Batangas, Philippines. Diabetes Res Clin Pract. 2010; 90:160–166.
13. Health Quality Ontario. Behavioural interventions for type 2 diabetes: an evidence-based analysis. Ont Health Technol Assess Ser. 2009; 9:1–45.
14. Sohal T, Sohal P, King-Shier KM, Khan NA. Barriers and facilitators for type-2 diabetes management in South Asians: a systematic review. PLoS One. 2015; 10:e0136202.
15. Graziani C, Rosenthal MP, Diamond JJ. Diabetes education program use and patient-perceived barriers to attendance. Fam Med. 1999; 31:358–363.
16. Rhee MK, Cook CB, El-Kebbi I, Lyles RH, Dunbar VG, Panayioto RM, Berkowitz KJ, Boyd B, Broussard S, George CD. Barriers to diabetes education in urban patients: perceptions, patterns, and associated factors. Diabetes Educ. 2005; 31:410–417.
17. Coonrod BA, Betschart J, Harris MI. Frequency and determinants of diabetes patient education among adults in the U.S. population. Diabetes Care. 1994; 17:852–858.
18. Do YK, Eggleston KN. Educational disparities in quality of diabetes care in a universal health insurance system: evidence from the 2005 Korea National Health and Nutrition Examination Survey. Int J Qual Health Care. 2011; 23:397–404.
19. Icks A, Rathmann W, Haastert B, Mielck A, Holle R, Lowel H, Giani G, Meisinger C. KORA Studiengruppe. Quality of care and extent of complications in a population-based sample of patients with type 2 diabetes mellitus. The KORA survey 2000. Dtsch Med Wochenschr. 2006; 131:73–78.
20. Ruppert K, Uhler A, Siminerio L. Examining patient risk factors, comorbid conditions, participation, and physician referrals to a rural diabetes self-management education program. Diabetes Educ. 2010; 36:603–612.
21. Guralnik JM, Land KC, Blazer D, Fillenbaum GG, Branch LG. Educational status and active life expectancy among older blacks and whites. N Engl J Med. 1993; 329:110–116.
22. Sim KH, Wang BR, Noh JW, Lee MK, Kwon YD. Diabetes education compliance and knowledge among diabetes patients: analysis of patients who refuse diabetes education at an academic medical center. J Korean Diabetes. 2014; 15:51–56.
23. Sprague MA, Shultz JA, Branen LJ, Lambeth S, Hillers VN. Diabetes educators' perspectives on barriers for patients and educators in diabetes education. Diabetes Educ. 1999; 25:907–916.
24. Schafer I, Küver C, Wiese B, Pawels M, van den Bussche H, Kaduszkiewicz H. Identifying groups of nonparticipants in type 2 diabetes mellitus education. Am J Manag Care. 2013; 19:499–506.
25. Schafer I, Pawels M, Kuver C, Pohontsch NJ, Scherer M, van den Bussche H, Kaduszkiewicz H. Strategies for improving participation in diabetes education. A qualitative study. PLoS One. 2014; 9:e95035.
Full Text Links
  • DMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr