A structured group education programme for people with newly diagnosed type 2 diabetes can successfully change patients' attitudes and behaviour towards their condition and improve their health, according to a study published on bmj.com today.
Type 2 diabetes affects around 4-5% of European populations and consumes a disproportionate amount of health service resource. In the long-term, it can lead to serious complications such as blindness, kidney failure, and amputation. It is also associated with increased illness and premature death from heart disease.
Although the Diabetes National Service Framework in the UK promotes group structured education, until now, there has been no scientific evaluation and no programmes meeting all the quality criteria identified by the National Institute for Health and Clinical Excellence.
So researchers set out to test whether the DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) structured education programme could fill this evidence gap.
Their study involved 824 patients with newly diagnosed type 2 diabetes at 207 general practices in England and Scotland. The average age of participants was 59.5 years. Participants were divided into two groups. The intervention group received a six-hour structured group education programme delivered in the community by two trained health care professional educators. The control group received usual care. All patients were monitored over 12 months.
The intervention group showed a modest but significant weight loss (1.1kg) at 12 months. The proportion giving up smoking was also significantly higher in the intervention group.
However, there was no difference in blood glucose levels (HbA1c) between the groups.
Self-reported physical activity was greater in the intervention group at 4 months, but this difference was not present at 8 and 12 months. But there was a greater improvement in risk for coronary heart disease at 12 months.
The intervention group showed greater understanding of their illness and its seriousness. They showed a better perception of the duration of their diabetes and of their ability to affect the course of their diabetes through lifestyle changes. They also experienced less depression, which is often linked to poor blood sugar control and increased mortality in patients with diabetes.
In summary, this programme encapsulates a patient centred approach to diabetes care, say the authors. This trial has filled an existing gap in the evidence base and has shown that group structured education focused on behaviour change can successfully engage patients in starting additional effective lifestyle changes sustainable over 12 months from diagnosis, they conclude.
An accompanying editorial points out that the challenge is to maintain the patient centred emphasis beyond the initial delivery of the education programme.