A trial of empowerment-based education in type 2 diabetes--global rather than glycaemic benefits

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 (HbA(1c)), 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 HbA(1c) 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 self-help, 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.