Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2008 Mar 1;336(7642):491-5.
doi: 10.1136/bmj.39474.922025.BE. Epub 2008 Feb 14.

Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial

M J Davies  1 , S Heller, T C Skinner, M J Campbell, M E Carey, S Cradock, H M Dallosso, H Daly, Y Doherty, S Eaton, C Fox, L Oliver, K Rantell, G Rayman, K Khunti; Diabetes Education and Self Management for Ongoing and Newly Diagnosed Collaborative
Affiliations
Randomized Controlled Trial

Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial

M J Davies et al. BMJ. .

Erratum in

  • BMJ. 2008 Apr 19;336(7649):doi:10.1136/bmj.39553.528299.AD

Abstract

Objective: To evaluate the effectiveness of a structured group education programme on biomedical, psychosocial, and lifestyle measures in people with newly diagnosed type 2 diabetes.

Design: 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: 824 adults (55% men, mean age 59.5 years).

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: Haemoglobin 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 and up to 12 months.

Main results: Haemoglobin A(1c) levels at 12 months had 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: 0.05% (95% confidence interval -0.10% to 0.20%). The intervention group showed a greater weight loss: -2.98 kg (95% confidence interval -3.54 to -2.41) compared with 1.86 kg (-2.44 to -1.28), P=0.027 at 12 months. The odds of not smoking were 3.56 (95% confidence interval 1.11 to 11.45), P=0.033 higher in the intervention group at 12 months. The intervention group showed significantly greater changes in illness belief scores (P=0.001); directions of change were positive indicating greater understanding of diabetes. The intervention group had a lower depression score at 12 months: mean difference was -0.50 (95% confidence interval -0.96 to -0.04); P=0.032. A positive association was found between change in perceived personal responsibility and weight loss at 12 months (beta=0.12; P=0.008).

Conclusion: A structured group education programme 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 haemoglobin A(1c) levels up to 12 months after diagnosis.

Trial registration: Current Controlled Trials ISRCTN17844016 [controlled-trials.com].

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

None
Referral numbers and flow of patients through trial
See this image and copyright information in PMC

Comment in

References

    1. International Diabetes Federation. IDF diabetes atlas—prevalence estimates of diabetes mellitus. www.eatlas.idf.org 2007.
    1. Massi-Benedetti M. The cost of diabetes type II in Europe: the CODE-2 study. Diabetologia 2002;45:S1-4. - PubMed
    1. Khunti K, Gadsby R, Millett C, Majeed A, Davies M. Quality of diabetes care in the UK: comparison of published quality-of-care reports with results of the Quality and Outcomes Framework for Diabetes. Diabetic Medicine 2007;24:1436-41. - PubMed
    1. Morris AD. Considerations in assessing effectiveness and costs of diabetes care: lessons from DARTS. Diabetes Metab Res Rev 2002;18:S32-5. - PubMed
    1. Skinner T, Cradock S, Arundel F, Graham W. Four theories and a philosophy: self-management education for individuals newly diagnosed with type 2 diabetes. Diabetes Spectr 2003;16:75-80.

Publication types

Associated data