A study by Davies and coworkers sought to evaluate the effectiveness of a structured group education program on biomedical, psychosocial, and lifestyle measures in people with newly diagnosed type 2 diabetes. The investigation featured a randomized controlled trial in 207 general practices at 13 primary care sites in the United Kingdom; a total of 824 adults (55% men, mean age 59.5 years) participated. The intervention was a structured group education program of six hours delivered by two trained health care professions that was compared to usual care. A variety of outcome measures were assessed, including hemoglobin A(1c) levels, blood pressure, weight, blood lipid levels, smoking status, physical activity, quality of life, beliefs about illness, depression, and emotional impact of diabetes at baseline up to 12 months. Hemoglobin A(1c) levels at 12 months decreased by 1.49% in the intervention group compared with 1.21% in the control group. After adjusting for baseline and cluster, the difference was not significant. The intervention group showed a greater weight loss at 12 months. The odds of not smoking were higher in the intervention group at 12 months. The intervention group showed significantly greater changes in illness belief scores; directions of change were positive indicating greater understanding of diabetes. The intervention group also had a lower depression score at 12 months. A positive association was found between change in perceived personal responsibility and weight loss at 12 months.

WHAT THE STUDY MAY MEAN TO YOU: The authors concluded that a structured group education program for patients with newly diagnosed type 2 diabetes resulted in greater improvements in weight loss and smoking cessation and positive improvements in beliefs about illness but no difference in hemoglobin A(1c) levels up to 12 months after diagnosis. This was an impressive study with a large number of subjects and a wide variety of outcome variables. It would be an even bigger contribution, however, if the patients were followed for two or more years.

MJ Davies et al. Effectiveness of the diabetes education and self-management for ongoing and newly diagnosed (DESMOND) program for people with newly diagnosed type 2 diabetes: cluster randomized controlled trial. British Medical Journal, February 14, 2008.