Effectiveness of a diabetes education and self management programme (DESMOND) for people with newly diagnosed type 2 diabetes mellitus:

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.

Design Three year follow-up of a multicentre cluster randomised
controlled trial in primary care, with randomisation at practice level.

Setting 207 general practices in 13 primary care sites in the United
Kingdom.

Participants 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.

Intervention A structured group education programme for six hours
delivered in the community by two trained healthcare professional
educators compared with usual care.

Main outcome measures The primary outcome was glycated
haemoglobin (HbA1c) 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 HbA1c 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.

Conclusion 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.


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