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Education intervention improved HbA1c in newly diagnosed type 2 diabetes

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Diabetes education programs for patients recently diagnosed with type 2 diabetes maintained improvements in some illnesses, but provided no difference in biomedical or lifestyle outcomes after 3 years, according to data from a randomized controlled trial initiated in the United Kingdom.

“Evidence of the long-term impact of structured education interventions in people with diabetes is currently lacking,” the researchers wrote.

Kamlesh Khunti, PhD, MD, professor of primary care diabetes and vascular medicine at the University of Leicester, United Kingdom, and colleagues conducted a 3-year follow-up of a randomized controlled trial in primary care, with randomization at practice level and a 6-hour education program.

Participants included 731 of the 824 patients included in the original trial who were eligible for follow-up. Biomedical data were collected for 604 patients, and questionnaires were collected from 513 patients, the researchers wrote.

The diabetes education and self-management for ongoing and newly diagnosed (DESMOND) intervention categorized patients into two groups (intervention and control) within 6 weeks of diagnosis. Researchers reported a sustained decrease in HbA1c levels at 3 years of –1.32% (95% CI, –1.57 to –1.06) in the intervention group and –0.81% (95% CI, –1.02 to –0.59) in the control group.

In an accompanying editorial, Frank J. Snoek, PhD, associate professor of medical psychology at the VU University Medical Centre in the Netherlands, said young and old patients with type 1 or type 2 diabetes must develop skills in self-management to successfully care for their condition.

Snoek cited a previous trial that examined the DESMOND program and how it changed patients’ attitudes toward their condition and improved health during a 12-month period. However, no long-term effect was discovered.

“Khunti and colleagues rightly point to the need for additional ongoing education and support in primary diabetes care to help sustain the initial benefits of the self-management program,” Snoek wrote. “It is important to understand the association between the skills of practitioners, patients’ self-management behaviours, and subsequent health outcomes for patients with diabetes, but we must not lose sight of the importance of glycaemic control.”

The researchers wrote that further studies are required to incorporate a longer follow-up period to assess intervention effects over time.

Disclosure: The researchers report no relevant financial disclosures.