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Short Diabetes Education Program Can Improve Control after Diagnosis

Attending a brief diabetes education program helps glycemic control in newly diagnosed patients…. 

The program consisted of 5 to 7 hours of education spread over 1 or 2 days, covering diabetes management, diet and exercise, managing stress, monitoring glucose levels and medication.

Matthew James (University of Calgary, Alberta, Canada) and co-workers studied 802 patients with newly diagnosed diabetes who attended the program within 6 months of diagnosis and matched them by propensity to attend the program with 802 patients drawn from a total 6,990 who did not attend.

The average baseline HbA1c in both groups was 7.61%, (59.7 mmol/mol). Over the next 6 to 18 months, the average HbA1c fell by 0.3% (3.3 mmol/mol) more in patients who attended the program than those who did not, after accounting for age, baseline HbA1c and the average time to follow-up measurement.

The researchers say that despite being a very brief intervention, the improvement in glycemic control achieved with the program is comparable to the upper end of the range seen for more extensive educational programs in patients with established diabetes. They suggest "it is possible that the effect of educational interventions may be greater in people with newly diagnosed disease."

Furthermore, the effect was larger as patients’ baseline HbA1c increased, with the size of reduction associated with the program rising from 0.25% (2.7 mmol/mol) at a baseline HbA1c of 7% (53 mmol/mol) to 0.56% (6.2 mmol/mol) at a baseline HbA1c of 11% (97 mmol/mol).

One of the authors, M.T. James added that although the additional HbA1c reduction associated with program participation was "small by clinical standards, it could have important benefits at a population level" in terms of overall number of complications prevented.

They caution that follow-up is needed to see if the reduction in HbA1c is sustained over the long term, but note that "these findings have important implications for program delivery, as the program used was a relatively low-cost intervention that can be readily scaled up for broader delivery."

Practice Pearls:

  • A short education program at diagnosis can be beneficial in lowering HbA1c
  • The study shows that education programs can play a role in reducing blood sugars

Diabet Med 2014; Advance online publication