Education boosts glycaemic control after diabetes diagnosis

By Eleanor McDermid, Senior medwireNews Reporter

Attending a brief diabetes education programme enhances the glycaemic control achieved by patients newly diagnosed, research suggests.

The programme, called Diabetes Essentials, 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 programme within 6 months of diagnosis and matched them by propensity to attend the programme with 802 patients drawn from a total 6990 who did not attend.

The average baseline glycated haemoglobin (HbA1c) in both groups was 7.61%, or 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 programme 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 glycaemic control achieved with the Diabetes Essential programme is comparable to the upper end of the range seen for more extensive educational programmes 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 programme 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).

Writing in Diabetic Medicine, James and team say that although the additional HbA1c reduction associated with programme 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 programme delivery, as Diabetes Essentials is a relatively low-cost intervention that can be readily scaled up for broader delivery.”

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