Background/Aims: Group diabetes education for patients is cost-efficient and could be more effective than an individual approach. The objective is to determine whether outcomes of group education are comparable to individual education in the short-term.
Methods: We identified 9,971 patients from two healthcare systems, ABQ Health Partners in New Mexico and HealthPartners in Minnesota, through electronic health records (EHR) with type 2 diabetes (T2DM) diagnostic codes and sub-optimal blood sugar control (A1c > 7%). Invitations were mailed from June 2008 - May 2009 and 623 (6.2% participation) subjects were randomized to: (1) Individual Education (IE), (2) Group Education (GE), or (3) Usual Care (UC)/no education. Education was delivered through the American Diabetes Association-recognized education programs of the participant’s care system. IE used a conventional approach with three 1-hr sessions, and GE used four 2-hr sessions using the U.S. Diabetes Conversation Map® education program. Psychosocial and behavioral measures were survey-assessed at baseline, 1, and 4 months after the last scheduled educational session. Clinical measures were obtained through the patient’s EHR in the 6 months preceding baseline & randomization and preceding the second follow-up survey. General and linear mixed modeling methods were used to assess patient changes from baseline to follow-up in A1c, General Health Status (SF-12), Problem Areas in Diabetes (PAID), Diabetes Empowerment Scale (DES), components of the Diabetes Care Profile (DCP), Readiness to Change (RTC), Recommended Food Score (RFS), and physical activity (PA) using the BRFSS.
Results: At follow-up, the mean A1c for IE decreased .61% (p<.001), .36% for GE (p=.003) and .34% for UC (p=.01). The A1c for IE decreased by .27% compared to UC (p=.02) and .25% compared to GE (p=.01). Compared to UC, mean PAID was reduced by IE (-.37, p=.02) and GE (-.30, p=.05) and SF12 physical health score, PA, and RFS were increased by IE 1.98 (p=.03), 41.17 minutes/week (p=.05), and.62 (p=.06), respectively. DES, RTC, and DCP were not significantly changed by IE or GE.
Conclusion: At 4 months post-education completion, individual education for this patient population resulted in improved A1c’s compared to usual care and group education. Diabetes-specific distress (PAID score) was reduced with both methods of education.