title: Comparative effectiveness of patient education methods for type 2 diabetes: a randomized controlled trial.
abstract: BACKGROUND
  Group education for patients with suboptimally controlled diabetes has not been rigorously studied.
  
  
  METHODS
  A total of 623 adults from Minnesota and New Mexico with type 2 diabetes and glycosylated hemoglobin (HbA(1c)) concentrations of 7% or higher were randomized to (1) group education (using the US Diabetes Conversation Map program), (2) individual education, or (3) usual care (UC; ie, no assigned education). Both education methods covered content as needed to meet national standards for diabetes self-management education and were delivered through accredited programs from 2008 to 2009. General linear mixed-model methods assessed patient-level changes between treatment groups in mean HbA(1c) levels from baseline to follow-up at 6.8 months. Secondary outcomes included mean change in general health status (Medical Outcomes Study 12-Item Short Form Health Survey [SF-12]), Problem Areas in Diabetes (PAID), Diabetes Self-Efficacy (DES-SF), Recommended Food Score (RFS), and Physical Activity (PA, min/wk).
  
  
  RESULTS
  Mean HbA(1c) concentration decreased in all groups but significantly more with individual (-0.51%) than group education (-0.27%) (P = .01) and UC (-0.24%) (P = .01). The proportion of subjects with follow-up HbA(1c) concentration lower than 7% was greater for individual education (21.2%) than for group (13.9%) and UC (12.8%) (P = .03). Compared with UC, individual education (but not group) improved SF-12 physical component score (+1.88) (P = .04), PA (+42.95 min/wk) (P = .03), and RFS (+0.63) (P = .05). Compared with group education, individual education reduced PAID (-3.62) (P = .02) and increased self-efficacy (+0.1) (P = .04).
  
  
  CONCLUSIONS
  Individual education for patients with established suboptimally controlled diabetes resulted in better glucose control outcomes than did group education using Conversation Maps. There was also a trend toward better psychosocial and behavioral outcomes with individual education.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00652509.
authors: HealthPartners Research Foundation and HealthPartners Medical Group, Minneapolis, MN 55440, USA. joann.m.sperlhillen@healthpartners.com
authors: JoAnn
authors: J
authors: Sperl-Hillen
authors: Sarah
authors: S
authors: Beaton
authors: Omar
authors: O
authors: Fernandes
authors: Ann
authors: A
authors: Von Worley
authors: Gabriela
authors: G
authors: Vazquez-Benitez
authors: Emily
authors: E
authors: Parker
authors: Ann
authors: A
authors: Hanson
authors: Jodi
authors: J
authors: Lavin-Tompkins
authors: Patricia
authors: P
authors: Glasrud
authors: Herbert
authors: H
authors: Davis
authors: Kenneth
authors: K
authors: Adams
authors: William
authors: W
authors: Parsons
authors: C Victor
authors: CV
authors: Spain
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009516:New Mexico; D010353:Patient Education as Topic / Q000379:methods*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human