Influence of health education on clinical parameters in type 2 diabetic subjects with and without hypertension: a longitudinal, comparative analysis in routine primary care settings

Aim: To assess the influence of health education for type 2 diabetic patients with and without coexisting hypertension in routine primary care where intensive educational consultations were absent. Methods: A longitudinal cohort was constructed from 342 diabetic subjects who previously had regular exposure to face-to-face health education delivered quarterly during 2016–2017 under the national basic public health (BPH) service provision in an urbanised township in China. Clinical parameters were retrieved electronically from computerised BPH data platform at prior check-ups (2016–2017) and at the most recent check-up (2019). Results: The satisfactory clinical improvements upon health education were not sustained during subsequent observational years among study subjects. A significant increase in total cholesterol (0.28 mmol/L for between-group net changes, 95% confidence interval [CI] = 0.01–0.55 mmol/L, p = 0.039) were observed in diabetic subjects with coexisting hypertension. Older patients (adjusted odds ratio [aOR] = 0.87, 95%CI = 0.83–0.91, p less than 0.001), males (aOR = 0.50, 95%CI = 0.26–0.98, p = 0.043), and subjects with lower education level (aOR = 0.34, 95%CI = 0.17–0.67, p = 0.002) were less likely to maintain improvement of biomedical parameters. Conclusion: The influence of face-to-face health education may not be prolonged in routine primary care where intensive provisions of educational consultations were less common. Diabetic patients with coexisting hypertension tend to have more difficulties in maintaining optimal lipid profiles.