Cost Savings and Clinical Effectiveness of an Extension Service Diabetes Program

Abstract

Objective. To evaluate the cost savings and clinical effectiveness of a Cooperative Extension Service diabetes education program for improving nutrition knowledge, food portioning skills, hemoglobin A_1c (A1C), and anthropometric indices.

Design. Clients with type 1 or type 2 diabetes enrolled in a 3-month diabetes education course focused on food portioning skills. Pre- and post-course anthropometric measurements, a written food portion test, an observational food portioning skill test, and an A1C test were administered and scored. Paired t tests were calculated between pre- and post-course scores to measure statistical significance.

Results. Data analysis showed improvement in food portion knowledge written test scores (49.67% pre- and 59.56% post-course, P = 0.004), food portioning skills (out of a possible score of 5, 2.43 pre-, 4.29 post-course, P = 0.023), A1C results (7.16% pre-, 6.43% post-course, P = 0.000), body mass index (BMI) (32.60 kg/m² pre-, 31.78 kg/m² post-course, P = 0.000), weight (202.58 lb pre-, 199.74 lb post-course, P = 0.000), waist circumference (42.43 inches pre-, 41.16 inches post-course, P = 0.000), hip circumference (45.96 inches pre-, 45.36 inches post-course, P = 0.000), and waist-to-hip ratio (0.92 pre-, 0.91 post-course, P = 0.000).

Conclusions/Applications. Evaluation of the Utah State University Extension Service diabetes education program showed improved nutrition knowledge, anthropometric measures, and glucose control. These improvements have been estimated to reduce medical costs by $94,010.