Abstract
Patients with poorly controlled Type 2 diabetes on maximal doses of oral hypoglycaemic therapy can be difficult to treat. The purpose of this single group pre test/postβtest study was to evaluate the use of three diabetesβspecific questionnaires as a clinical tool for improving patients' HbA ~1c~ levels. The trial group of 52 patients acted as their own controls and data on each patient prior to the study was reviewed. Questionnaire scores were used to guide the patients toward a decision about treatment choices. By chance, twentyβsix patients chose to commence insulin therapy (IG) and twentyβsix patients chose to remain on oral therapy (OG). At three months both groups had significantly improved their selfcare and psychosocial scores and had very significantly reduced their HbA~1c~ levels(IG: 10.5Β± 1.4to8.55Β± 1.3, p=0.0000049; OG: 10.05Β± 1.4to8.6Β± 1.3,p= 0.000003). The study finished at this stage but at nine months all the patients, regardless of treatment, had maintained their improvements in glycaemic control. The insulin group had gained significant weight (p = 0.008) whilst the oral group had lost weight but not significantly so (p = 0.059). The results demonstrate the value of empowering patients to make informed decisions about their treatment.