Group education for obese patients with type 2 diabetes: greater success at less cost.
It has been suggested that much effort expended in teaching diabetic diets is ineffective and wasteful. We have tested a different system by randomly allocating 75 newly diagnosed obese Type 2 diabetic patients to usual 'unstructured' clinic care or to group education by diabetes specialist nurses and a dietitian. Patients allocated to group education attended five 90-min group sessions during the first 6 months. Six months after diagnosis they had lost more weight (median (95% Cl), 7 (5.5-9) vs 2(1-5)kg, p less than 0.002) and were better controlled (HbA1:7.5 (7.0-8.1) vs 9.5 (8.7-10.4)%, p less than 0.001) than those randomized to the usual clinic system. At 1 year (after no further visits) the difference in weight loss was less (5.5 (4-6.5) vs 3 (2-4) kg, p less than 0.05) and diabetic control was similar (HbA1:9.0(8.2-9.8) vs 9.9(8.9-10.9)%. At 1 year only 14(39%) of the education group and 9(23%) of those attending the clinic had a fasting blood glucose less than 7.0 mmol l-1.
Heller
S R
SR
Department of Medicine, University Hospital, Nottingham, UK.
Clarke
P
P
Daly
H
H
Davis
I
I
McCulloch
D K
DK
Allison
S P
SP
Tattersall
R B
RB
D001786:Blood Glucose / Q000032:analysis; D003365:Costs and Cost Analysis; D003920:Diabetes Mellitus / Q000097:blood / Q000534:rehabilitation*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000534:rehabilitation*; D003927:Diet, Diabetic; D004521:Educational Measurement; D004739:England; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity; D010353:Patient Education as Topic / Q000191:economics / Q000379:methods*; D011795:Surveys and Questionnaires
D001786:Blood Glucose; D006442:Glycated Hemoglobin