Advanced diabetes training for doctors and staff help cut down on incidences of low blood-sugar and other associated problems, a new study in the Journal of the American Medical Directors Association has found.

The project drew small sample sizes and was focused on a single problem—diabetes—but the researchers think that their work might be a model for patient care in other areas, too.

“Focused quality improvement activities have the potential to catalyze changes in patient care, particularly those with complex management requirements and chronic disease,” Patrick Boyle, MD, wrote for the research team. “These data are encouraging and indicative of better patient oversight.”

Researchers hosted intense focus groups and workshops with doctors and other staff in two Brookdale Senior Living homes in Florida. The training targeted patients who were early into their transitions into the homes, the group that many consider to be most vulnerable to health problems in long term care, Boyle wrote for his associates. The results were dramatic.

The focused efforts “demonstrated important improvements,” with patients reporting lower cholesterol levels, increased physical activities, and more attention to the foot problems that so often plague people with diabetes, Boyle wrote.

“Perhaps the most important finding for this population of elderly residents, most of whom are older than 75 years of age, is the significant reduction in hypoglycemic events,” Boyle wrote.

Incidents of low blood sugar fell dramatically after the advanced training—by 18 percent in patients over their first three months, Boyle reported. Even five months after the workshops, hypoglycemia remained down by 11 percent among residents, the researchers found.

Among the elderly, low blood sugar has been shown to correlate with blood pressure problems, falls, and even death, Boyle wrote.

The quality initiative proceeded in four phases, using everything from focus groups to retrospective charts of patient care, Boyle said. Phase 2 of the experiment was built around three, two-hour continuing education courses—one set for doctors and the other for nurses and other staff.

“Both physician and nonphysician groups demonstrated a need for education surrounding the appropriate use of noninsulin agents, sliding scale insulin (SSI), and nutritional guidelines for patients with diabetes,” Boyle wrote.

Initially, doctors and staff didn’t have a lot of confidence in their skills at dealing with diabetes, Boyle reported. Only 29 percent of doctors and staff said they were “mostly” or “extremely” confident in their handling of noninsulin agents or insulin agents. Less than half had confidence in their knowledge of the relationship between insulin and meals. And barely two-fifths were even “somewhat comfortable” in spotting the symptoms of low blood sugar, Boyle wrote.