title: Utilization of Diabetes Education Centres in Ontario by people without diabetes.
abstract: OBJECTIVE
  The aim of this study was to describe the utilization of diabetes education centres by people not diagnosed with diabetes mellitus in real-world clinical care in Ontario.
  
  
  METHODS
  Using population-level health administrative databases and registries, all people in Ontario, Canada, who attended a diabetes self-management education centre in 2006 were identified. The proportion of attendees without diagnosed diabetes at the time of their visit was determined, they were stratified by centre and health region, and their utilization of diabetes education centres was characterized. They were then followed up until 2010 for incident diabetes.
  
  
  RESULTS
  Of 117,660 adults attending a diabetes education centre, 19,920 (16.9%) did not have diagnosed diabetes. There was a marked variation in the proportion of attendees without diagnosed diabetes between health regions and between individual centres. More attendees did not have diagnosed diabetes at centres based in community health centres (47.5%) or First Nations communities (22.1%) than those based in hospitals (13.9%) or other community settings (13.0%). Only 2741 attendees (13.8%) without diabetes attended group education classes; most attended individual counselling sessions. Diabetes incidence during follow up was 11.2 cases per 100 person years.
  
  
  CONCLUSIONS
  One in 6 people receiving care at a diabetes education centre in Ontario did not have diabetes, and the significant regional variations could represent inappropriate overuse or underuse. Although education and counselling for patients at risk for diabetes is clinically important, the volume of such persons served at Ontario diabetes education centres may detract from the centres' core function of supporting and managing patients already diagnosed with diabetes.
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Hwee
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Cauch-Dudek
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
authors.forename: J Charles
authors.initials: JC
authors.lastname: Victor
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors.forename: Ryan
authors.initials: R
authors.lastname: Ng
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: baiju.shah@ices.on.ca.
authors.forename: Baiju R
authors.initials: BR
authors.lastname: Shah
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003376:Counseling / Q000706:statistics & numerical data*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012042:Registries; D018570:Risk Assessment; D012648:Self Care / Q000592:standards / Q000639:trends; D012944:Social Support
keywords: centre d’enseignement sur le diabète; diabetes education centres; fréquentation; health services research; recherche de services de santé; utilization