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Educational Interventions Modestly Improve Glucose Control

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‘Modest’ Improvement Isn’t Surprising

Readers must remember that both of these studies involved patients with longstanding diabetes who were taking medical therapy and therefore must have received various forms of diabetes education in the past. Yet, they still had poorly controlled disease, even in this "high-functioning clinical setting," said Dr. Ralph Gonzales and Margaret A. Handley, Ph.D.

"In this light, it is not surprising to find minimal or modest effects of the educational programs on glycemic control, since counseling-based behavior change interventions depend heavily on a patient’s readiness to change and self-efficacy related to diabetes self-management," they noted.

Dr. Gonzales and Dr. Handley are in the department of medicine and the department of epidemiology and biostatistics at the University of California San Francisco. They reported no financial conflicts of interest. These remarks were taken from their editorial comment accompanying the reports by Dr. Weinger and Dr. Sperl-Hillen (Arch. Intern. Med. 2011 Oct. 10 [doi:10.1001/archinternmed. 2011.496]).


 

FROM ARCHIVES OF INTERNAL MEDICINE

Fewer subjects receiving the group intervention than those receiving the individual intervention completed the program, probably because of scheduling difficulties, the authors wrote. Nevertheless, in an analysis restricted to subjects who completed their programs, the results were still better with the individual than with the group intervention.

"We believe that these short-term results support the use of individual diabetes education for this patient population," the investigators said.

Dr. Weinger’s study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institutes of Health, and the Joslin Diabetes Center Clinical Research Center. Abbott Laboratories, LifeScan, and Roche Diagnostics contributed glucose meters and test strips. Dr. Weinger’s associate reported ties to Eli Lilly, Amylin Pharmaceuticals, Takeda, Sanofi-Aventis, and Daiichi-Sankyo. Dr. Sperl-Hillen’s study was funded by Merck. Dr. Sperl-Hillen reported ties to Merck, GlaxoSmithKline, Lilly, and Schering-Plough.

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