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Self-management Education: Which Type is Best?

Patient education and self-management are cornerstones of treatment for diabetes, and there are many reports that educational programs do help reduce blood glucose levels. Researchers in Boston tested two different types of education programs to see if one type provoked more improvement than the other.

Patients with HbA1c levels over 8.5 percent received either intensive education or passive education. The intensive program involved three and a half days of a structured curriculum presented by a doctor, nurse, nutritionist, pharmacist, exercise physiologist and a social worker. The other group received materials in the mail every three months providing basic information on topics related to diabetes management. The patients continued care with their regular diabetes care provider during the study period.

After a year both groups had significant reductions in the HbA1c levels, and there was no difference between the groups. The intensive group had a two percent reduction, while those in the passive education group dropped 1.9 percent. Both groups had a significantly greater decline than people in a matched control group with similar HbA1c levels who received no education.

Another new study also found that blood glucose levels improved after self-management education, but the improvement declined one to three months after the educational program ended.

For years the recommended education formula for diabetes patients has been to give enough information initially to get them through the diagnosis and then follow that with a thorough education program that covers the main topics of self-management. As this study shows, people need re-education and renewed motivation every few months.


  • Raji A, Gomes H, Beard JO. A randomized trial comparing intensive and passive education in patients with diabetes mellitus. Archives of Internal Medicine, June 10, 2002;162:1301-1304. (Abs.)
  • Norris SL, Lau J, Smith SJ, et al. Self-management education for adults with type 2 diabetes. Diabetes Care, July 2002;25:1159-1171. (Abs.)

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