Type 2 Diabetes - Ongoing And Continuous Clinical Support Crucial

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Main Category: Diabetes
Article Date: 14 Jun 2012 - 11:00 PST


A new study has found that patients diagnosed with Type 2 diabetes are more likely to benefit in the long term if they receive ongoing and sustained clinical support instead of a one-off session when they are first diagnosed.

The study, published in British Medical Journal (BMJ), was conducted by Professor Kamlesh Khunti, of the University of Leicester, and Professor Melanie Davies, of the University of Leicester and Leicester hospitals, with colleagues from the Leicester Diabetes Center.

The researchers explained:

"In recent years, programs to educate people with Type 2 diabetes about self management have become the focus of attention among healthcare professionals and are advocated for people with the condition. Yet few established self management education programs have reported long term effects of the intervention."

The researchers examined three year follow-up data on 731 individuals newly diagnosed with Type 2 diabetes from over 200 general practices. At the start of the study participants were randomly assigned to receive either a one-day self-management education program (DESMOND) or usual GP care.

The researchers found that patients in the intervention group sustained 4 out of 5 health beliefs (seen at 12 months) at three years. Although HbA1c levels decreased in both groups at three years, the difference was not significant. In addition, the team found no difference between both groups for other biomedical and lifestyle outcomes and drug use. Quality of life and depression scores did not differ at three years.

Professor Kamlesh Khunti at the University of Leicester, explained: "It demonstrates that these patients need care planning and ongoing structured education rather than a one-off program when they are diagnosed - in order to see continued benefits with regard to lifestyle and biomedical outcomes."

The researchers believe that the DESMOND program at diagnosis is beneficial for psychosocial outcomes. They state that: "although these benefits are important it remains uncertain at what stage, if ever, biomedical benefits emerge in people with newly diagnosed type 2 diabetes and whether in the longer term a relation between the two translates into more effective self management to maintain glycaemic control." Earlier studies demonstrated that these types of programs are cost-effective to implement in practice.

According to the researchers, "participants may need further education and ongoing support to successfully manage their condition and to achieve improvements to clinical outcomes and self management behaviors long term."

Dr Iain Frame, Director of Research for Diabetes UK, explained:

"We welcome new research into structured education because we see structured education with a healthcare team as an important part of ensuring that people with diabetes have the tools to manage their own condition. This is why we continue to fund research into making sure it is as effective as possible to meet the needs of people with the condition."

In an associated report, Professor Frank Snoek, from the VU university medical center in the Netherlands, explained that different illness beliefs do not have the same relevance for maintaining acquired behavior changes at a later stage and stressed the importance of glycaemic control for a population with type 2 diabetes. "We should focus again on the setting of appropriate targets by professionals who care for patients with diabetes and the patients themselves," he said.

Written By Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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