Endocrine Abstracts

The Republic of Belarus gained 20 years of experience in teaching patients self-control of diabetes mellitus and hypothyroidism.

Learning technique consists of work in small groups (5 to 6 people). Patients with newly diagnosed disease are subjects to training (one step). Then weekly at outpatient clinics they attend classes on specific subjects (duration of class is 1 hr). Each class consists of a short lecture, analysis of clinical cases, a class discussion of the results. Subjects of classes are regulated and approved by the Ministry of Health. Today at the Republic of Belarus function 237 schools of diabetes and 18 hypothyroidism schools.

Learning outcomes lead to better control of diabetes at home during long-term observation of HbA1c levels. During the first 2 years the amount of severe ketoacidosis halved and the incidence of hypoglycemia is three times lower. During 10 years period in patients, who perform self-control, the number of amputations because of diabetic foot syndrome decreased by 15%.

However, introduction of self-control teaching system in endocrinology has its problems.

i) Doctors and physician assistants not always have sufficient teaching skills which reduces the patient’ motivation to perform self-control.

ii) Among medical personal there is a lack of interest in patient’ self-control diary. Because of that at the Department of Endocrinology is conducted special training of teachers in order to prepare them for schools of diabetes.

iii) Training of patients with hypothyroidism is more difficult not only for teacher but for the patients themselves. These issues are currently relevant for endocrinologist that are connected with teaching process of such patients and are the subject of discussion at the meetings of the Republican Association of Endocrinologists. Teaching guidelines of self-control in hypothyroidism are being prepared to be issued.