Experience-based group education in Type 2 diabetes: a randomised controlled trial

Patient Educ Couns. 2004 Jun;53(3):291-8. doi: 10.1016/j.pec.2003.10.009.

Abstract

Few studies have demonstrated an effect of educational interventions on glycaemic control in persons with Type 2 diabetes longer than 3-6 months after baseline. We aimed to investigate the effectiveness of an experience-based group educational programme 24 months after baseline and to pinpoint mediators that might play a role in achieving desired metabolic outcomes. We conducted a randomised controlled trial inviting self-referred persons with Type 2 diabetes (N=77 randomised). The pharmacist-led, year-long intervention was based on participants' experiences of glucose regulation during the monthly group discussions. We measured HbA1c at 0, 6, 12, and 24 months and a questionnaire was administered at baseline and final follow-up. Our findings indicated that participating in the intervention programme significantly decreased HbA1c by 0.4% at 24 months after baseline. Initial HbA1c, satisfaction with own diabetes-related knowledge, and treatment were found directly related to glycaemic outcomes. The intervention group exercised more in order to lower blood-glucose levels and was also more able to predict current blood-glucose levels before measuring it. Experience-based group education was effective in decreasing participants' HbA1c 1-year after completed intervention. Early effect of the intervention was followed by relapse after 12 months and a new, significant decrease at 24 months; this dual course implies that follow-up of educational interventions should involve several consecutive measurements to capture possible late effects. Both biomedical and subjective factors played a role in accounting for the variance of HbA1c at 2-year follow-up after baseline.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Attitude to Health
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diabetes Mellitus, Type 2 / psychology
  • Exercise Therapy
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / metabolism
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Nurse Clinicians / organization & administration
  • Patient Education as Topic / organization & administration*
  • Pharmacists / organization & administration
  • Problem-Based Learning / organization & administration*
  • Program Evaluation
  • Regression Analysis
  • Self Care / methods
  • Self Care / psychology
  • Self Efficacy
  • Self-Help Groups / organization & administration*
  • Surveys and Questionnaires
  • Sweden

Substances

  • Glycated Hemoglobin A