Level 2: Mid-level evidence

The Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) program for patients with type 2 diabetes was evaluated in a cluster-randomized trial (BMJ. 2008;336:491-495; full-text available online free of charge at: www.bmj.com/cgi/content/full/336/7642/491, accessed June 6, 2008). General practices in England and Scotland (N=207) were randomized to either intervention or control. Intervention practices provided a six-hour, structured, group-education program by trained health-care professionals to newly diagnosed type 2 patients. A total of 824 adults (mean age 59.5 years) consented to study enrollment within 12 weeks of diagnosis.

Comparing intervention vs. control at 12 months, 92% vs. 89% attended practice visits (outcomes included hemoglobin A1c [HbA1c], BP, body weight, lipid levels, and waist circumference); 75% vs. 73% completed a questionnaire (outcomes included smoking, physical activity, and quality of life). Mean weight loss was 2.98 kg vs. 1.86 kg (6.6 lb vs. 4.1 lb) (P=.027), mean change in HbA1c was -1.49% vs. -1.21% (not significant), and 11% vs. 16% reported smoking (P=.033) (but 14% vs. 16% reported smoking at baseline). There were no significant differences in physical activity, BP, lipid levels, or waist circumference.

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