title: The impact of diabetes counseling and education: clinical and cost outcomes from a large population of US managed care patients with type 2 diabetes.
abstract: The purpose of this study is to examine outcomes in adult patients with type 2 diabetes mellitus who received diabetes counseling and education (C/E) services compared with those who did not.
  
  
  
  A matched, retrospective cohort study of 17 483 C/E recipients and 17 470 non-C/E controls was followed for up to 12 months. Outcomes included glycemic control (glycosylated hemoglobin A1C levels <7.0%), hypoglycemic events, and health care utilization and costs.
  
  
  
  Compared with the non-C/E group, patients in the C/E group had significantly lower A1C (7.7% vs 7.2%) and were more likely to achieve glycemic control at 6 months' follow-up; they were also more likely to have a hypoglycemic event. During the 1-year period following the index date, C/E recipients had more inpatient visits (0.21 vs 0.20 visits per patient) and ambulatory visits (21.5 vs 18.6 visits per patient) compared with non-C/E controls. The increased use of health care services in the C/E groups was associated with $2388 higher annual overall costs and $827 higher diabetes-related costs.
  
  
  
  Diabetes C/E is associated with improved glycemic control, albeit with a slight increase in the risk of hypoglycemia. C/E was associated with higher health care costs across 12 months. Further analyses are needed to evaluate long-term cost-effectiveness of diabetes counseling and education.
authors: University of Washington, Seattle, Washington (Dr Sullivan)
authors: Sean D
authors: SD
authors: Sullivan
authors: Sanofi US, Inc, Bridgewater, New Jersey (Dr Dalal)
authors: Mehul R
authors: MR
authors: Dalal
authors: OPTUM Insight, Eden Prairie, Minnesota (Dr Burke)
authors: James P
authors: JP
authors: Burke
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000523:psychology*; D037001:Directive Counseling; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D010349:Patient Compliance; D010353:Patient Education as Topic; D015397:Program Evaluation; D012189:Retrospective Studies; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human