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A trial of empowerment-based education in type 2 diabetes -- global rather than glycaemic benefits
Cooper H, Booth K, Gill G
Insulin 2009 Nov;4(1):61-67
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

We have assessed the effect of a structured, empowerment-based educational system ("LAY or "Look After Yourself") for patients with type 2 diabetes. A randomised controlled trial (RCT) was conducted, testing the system against standard support. Using 3 centres, 89 patients participated in the study. Outcome measures included glycated haemoglobin (HbA1c), body mass index (BMI) and a variety of quantitative psychological and educational measures. Assessment was made at 6 months ("short-term") and 12 months ("long-term") post-intervention. The educational programme was associated with benefits in HbA1c levels (p = 0.005), illness attitudes (p = 0.04), and perceived treatment effectiveness (p = 0.03) at 6 months follow-up compared to controls. At 12 months however, only illness attitudes (p = 0.01), and self-monitoring (p = 0.002) showed benefit. A combined outcome measure showed positive benefit for the educational programme both at 6 months (p = 0.001) and 12 months (p = 0.002). This structured educational programme, aimed at encouraging selfhelp, was associated with only limited benefits in glycaemic control, but there were significant educational and psychological benefits. Diabetes education should be regarded as having broad patient-based positive outcomes, and should not be expected to have lasting benefits on glycaemic control.

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