État des connaissances des patients diabétiques de type 2 en médecine de ville et impact de l'éducation thérapeutique

Abstract : Introduction: Type 2 diabetes (T2DM) is a chronic disease with a prevalence of 4.4% in France. It is a pathology responsible for significant morbidity and mortality, representing a strong public health organization. Indeed, type 2 diabetes is the leading cause of blindness before the age of 65, the leading cause of hemodialysis and the fourth leading cause of hospitalization and death in France. The development of skills and the acquisition of knowledge, therapeutic education (ETP) enable the patient to better manage his illness. Materiel and methods: This is a retrospective, comparative, multicenter study whose main objective was to study the knowledge of patients with type 2 diabetes and to compare them with the knowledge of patients who have previously ETP. The secondary objectives of our study were to evaluate the impact of ETP on the quality of life of patients with type 2 diabetes and to carry out a first educational diagnosis, allowing us to identify the targets priority education. We formed 2 groups: the non-ETP group (patients who have never performed ETP sessions) and the ETP group (patients who have already completed ETP sessions). Results: 60 patients participated in this study, 30 patients in the ETP group, 30 patients in the non-ETP group. Patients in both groups had comparable epidemiological data: mean age was 63.8 years, BMI 29.6 kg / m2, duration of DT2 was 5-10 years, most patients were retired. 53% of the patients in the non-ETP group did not know their hypoglycemic treatments compared to 17% in the FTE group, this difference was statistically significant (p <0.01). Regarding the causes of DT2, we did not observe a significant difference between the 2 groups, there was a multifactorial origin of DT2 in both groups. In the non-ETP group: 83% of patients had knowledge of glycated hemoglobin, 57% of normal blood glucose, 37% of the hypoglycemia threshold. While in the ETP group: 100% of patients knew glycated hemoglobin, 97% normal values of blood glucose and 90% threshold value of hypoglycemia. We found a significant difference (p <0.01) between the 2 groups concerning the knowledge of these 3 values. The study of hypoglycemia resetting methods and the knowledge of possible disorders DT2 did not reveal any significant difference between the two groups. We studied the responses of the patients of both groups to some received ideas about DT2. In general, on the 10 received misconceptions, patients in the ETP group had a higher rate of correct answers than the non-ETP group. Regarding the quality of life of patients, we observed a statistically significant difference between the 2 groups: patients in the ETP group had a greater feeling of control over their DT2 (p = 0.07), a feeling of understanding of their disease more important (p <0.01) and felt more concerned about their DT2 (p <0.01). No significant difference in the feeling of impact of DT2 on their lives was observed between the 2 groups. Conclusion: Type 2 diabetes is a chronic condition whose goal is not healing but care to achieve a balance of health and life. This equilibrium requires a change in behavior, which is the goal of ETP.
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Roxane Mouyon. État des connaissances des patients diabétiques de type 2 en médecine de ville et impact de l'éducation thérapeutique. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02025230⟩

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