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Cited by 11Diabetes Management and EducationDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and Management

The effectiveness of a structured group education programme for people with established type 2 diabetes in a multi-ethnic population in primary care: a cluster randomised trial

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Dallosso, Helen, Mandalia, Panna, Gray, Laura J., Chudasama, Yogini V., Choudhury, Sopna, Taheri, Shahrad, Patel, Naina, Khunti, Kamlesh +1 more·2022·Nutrition Metabolism and Cardiovascular Diseases
DOI 10.1016/j.numecd.2022.03.017
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Abstract

Background and aims Structured self-management education has been shown to be effective in type 2 diabetes (T2DM) but more research is needed to look at culturally appropriate programmes in ethnic minority groups, where prevalence of T2DM is higher and diagnosis earlier. The study tested the effectiveness of a group education programme for people with established T2DM in a multi-ethnic primary care population.Methods and results Cluster randomised trial conducted in two multi-ethnic UK sites. Practices were randomised (1:1) to a structured T2DM group education programme or to continue with routine care. A culturally-adapted version was offered to South Asians, who formed the majority of ethnic minority participants. Other ethnic minority groups were invited to attend the standard programme. Primary outcome was change in HbA1c at 12 months. All analyses accounted for clustering and baseline value.367 participants (64(SD 10.8) years, 36% women, 34% from minority ethnic groups) were recruited from 31 clusters. At 12 months, there was no difference in mean change in HbA1c between the two groups (-0.10%; (95% CI: -0.37, 0.17). Subgroup analyses suggested the intervention was effective at lowering HbA1c in White European compared with ethnic minority groups. The intervention group lost more body weight than the control group (-0.82 kg at 6 months and -1.06 kg at 12 months; both p = 0.03).Conclusion Overall, the programme did not result in HbA1c improvement but in subgroup analysis, a beneficial effect occurred in White Europeans. Findings emphasise a need to develop and evaluate culturally-relevant programmes for ethnic minority groups.

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  • Diabetes self-management education and support interventions that were culturally appropriate were associated with better outcomes.

    “Better outcomes were reported for DSMES interventions that were more than 10 h over the course of 6-12 months (20), included ongoing support (14,32), were culturally (33)(34)(35) and age appropriate (36,37), were tailored to individual needs and preferences, addressed psychosocial issues, and incorporated behavioral strategies (15,26,38,39).”

    From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [33]

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Authors
Dallosso, H., Mandalia, P., Gray, L. J., Chudasama, Y. V., Choudhury, S., Taheri, S., Patel, N., Khunti, K., & Davies, M. J.
Affiliations
  • University Hospitals of Leicester NHS Trust (GB)
  • University of Leicester (GB)
  • University of Birmingham (GB)
Corresponding author
Dallosso, Helen
ORCID
Venue
Nutrition Metabolism and Cardiovascular Diseases
Publisher
Elsevier BV
Published
2022-06
Volume
32
Issue
6
Pages
1549-1559
ISSN
0939-4753 (ISSN-L)
DOI
10.1016/j.numecd.2022.03.017
OpenAlex
W4221050314
Cited by
11
References
30
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 1
FWCI
1.86
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrition Metabolism and Cardiovascular Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by-nc-nd)
Funders
National Institute for Health and Care Research
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
type 2 diabetes, self-management education, culturally tailored interventions, ethnic minorities, South Asians, HbA1c, weight loss, primary care, multi-ethnic population, subgroup analysis
MeSH terms
Diabetes Mellitus, Type 2, Ethnicity, Female, Glycated Hemoglobin, Humans, Male, Minority Groups, Primary Health Care

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