Supporting diabetes self-management in primary care: Pilot-study of a group-based programme focusing on diet and exercise

Aims: To develop and implement a group self-management education programme for people with type 2 diabetes at the community level in primary care. This pilot-study intended to evaluate the feasibility, acceptability and long-term effects (12-18 months) of this programme on emotional distress, HbA1c, BMI and actual behaviour. Methods: An empowerment-based, theory-driven education programme was evaluated in a before-after design. The programme focused on behaviour assessment, goal-setting, problem solving and tailored information. A diabetes specialist nurse conjointly with a dietician or psychologist led five 2-hour sessions and a follow-up meeting after 3 months. Results: Forty-four people participated in 5 groups. BMI decreased with 0.45 kg/m(2) (95%CI 0.01-0.89) at 12-month and with 0.53 kg/m(2) (95%CI 0.02-1.04) at 18-month follow-up. HbA1c declined from 7.4% (+1.3) to 6.8% (+0.8) (p = 0.040) and the PAID-score diminished from 28 (+20) to 18 (+13) (p =0.006) at 12-month post-intervention. These changes were only partly sustained at 18-month follow-up. Actual behaviour changed modestly. Conclusion: Introducing the group education programme in primary healthcare is worthwhile (feasibility and effectiveness). A detailed description of the intervention is offered. Further research should explore the actual education process in greater depth. (C) 2009 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.