title: Effectiveness of a diabetes education and self management programme (DESMOND) for people with newly diagnosed type 2 diabetes mellitus: three year follow-up of a cluster randomised controlled trial in primary care.
abstract: OBJECTIVE
  To measure whether the benefits of a single education and self management structured programme for people with newly diagnosed type 2 diabetes mellitus are sustained at three years.
  
  
  METHODS
  Three year follow-up of a multicentre cluster randomised controlled trial in primary care, with randomisation at practice level.
  
  
  METHODS
  207 general practices in 13 primary care sites in the United Kingdom.
  
  
  METHODS
  731 of the 824 participants included in the original trial were eligible for follow-up. Biomedical data were collected on 604 (82.6%) and questionnaire data on 513 (70.1%) participants.
  
  
  METHODS
  A structured group education programme for six hours delivered in the community by two trained healthcare professional educators compared with usual care.
  
  
  METHODS
  The primary outcome was glycated haemoglobin (HbA(1c)) levels. The secondary outcomes were blood pressure, weight, blood lipid levels, smoking status, physical activity, quality of life, beliefs about illness, depression, emotional impact of diabetes, and drug use at three years.
  
  
  RESULTS
  HbA(1c) levels at three years had decreased in both groups. After adjusting for baseline and cluster the difference was not significant (difference -0.02, 95% confidence interval -0.22 to 0.17). The groups did not differ for the other biomedical and lifestyle outcomes and drug use. The significant benefits in the intervention group across four out of five health beliefs seen at 12 months were sustained at three years (P<0.01). Depression scores and quality of life did not differ at three years.
  
  
  CONCLUSIONS
  A single programme for people with newly diagnosed type 2 diabetes mellitus showed no difference in biomedical or lifestyle outcomes at three years although there were sustained improvements in some illness beliefs.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN17844016.
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester LE1 6TP, UK. kk22@le.ac.uk
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Gray
authors.forename: Timothy
authors.initials: T
authors.lastname: Skinner
authors.forename: Marian E
authors.initials: ME
authors.lastname: Carey
authors.forename: Kathryn
authors.initials: K
authors.lastname: Realf
authors.forename: Helen
authors.initials: H
authors.lastname: Dallosso
authors.forename: Harriet
authors.initials: H
authors.lastname: Fisher
authors.forename: Michael
authors.initials: M
authors.lastname: Campbell
authors.forename: Simon
authors.initials: S
authors.lastname: Heller
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
mesh_terms: D000328:Adult; D017668:Age of Onset; D003695:Delivery of Health Care / Q000379:methods / Q000458:organization & administration; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006282:Health Personnel / Q000592:standards; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods / Q000458:organization & administration; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D011320:Primary Health Care / Q000379:methods / Q000458:organization & administration; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin