ASSESSMENT OF EFFICACY OF EDUCATION OF GENERAL PRACTITIONERS BY THE TRAINING PROGRAM FOR MANAGEMENT OF TYPE 2 DIABETES MELLITUS

Due to the insufficient number of endocrinologists, especially in rural areas, patients with diabetes mellitus (DM) are treated by primary care physicians and general practitioners. In these regions, the level of compensation in diabetic patients is extremely low; doctors often prescribe insulin, mainly due to low awareness of modern trends in therapy of diabetes. To improve the quality of medical and preventive care for diabetic patients in rural areas, employees of FSI Endocrinological Research Center of Ministry of Public Health and Social Development RF with the support of Novo Nordisk have developed the "Medical ambitions" project, in which training program "Modern approaches to diagnosis and treatment of type 2 diabetes mellitus" was prepared and implemented. This program was aimed to raising awareness of type 2 diabetes mellitus from primary care physicians and general practitioners and the intensification of therapeutic approaches to this disease. The program included two seminars (more than 120 doctors were trained), and their effectiveness was evaluated in 3 regions (Moscow Region, Tver Region, Khabarovsk Territory) by two criteria: the structure of antihyperglycemic therapy and the level of compensation of carbohydrate metabolism in patients with type 2 diabetes mellitus (n = 620) before and 12 months after the start of the project. The number of patients receiving peroral antihyperglycemic drugs (PAD) as monotherapy has decreased from 44.7 to 34.2%, and number of patients receiving insulin therapy increased from 18.4 to 23.3%. The doses of PAD and insulin have significantly increased, and intensification of insulin therapy was observed (the proportion of patients on premixed insulin increased from 22.4 to 33.3%, on insulin analogues - from 31.9 to 51.2%). Significant decrease in the average level of glycated hemoglobin (HbA1c) from 8.5 ± 2.8 to 7.4 ± 1.9% was noted, and the proportion of patients achieving target levels of HbA1c have increased from 15.4 to 50.2%.

type 2 diabetes mellitus, insulin therapy, training programs, therapists