Group Visits Improve Metabolic Control in Type 2 Diabetes
A 2-year follow-up
- Marina Trento, B. ED. SCI.1,
- Pietro Passera, MD1,
- Marco Tomalino, MD1,
- Marina Bajardi, B. PSYCH.1,
- Fulvio Pomero, MD1,
- Attilio Allione, MD1,
- Piero Vaccari, B. PSYCH.1,
- Gian Michele Molinatti, MD1 and
- Massimo Porta, MD, PHD1
OBJECTIVE—To evaluate whether group visits, delivered as routine diabetes care and structured according to a systemic education approach, are more effective than individual consultations in improving metabolic control in non–insulin-treated type 2 diabetes.
RESEARCH DESIGN AND METHODS—In a randomized controlled clinical trial of 112 patients, 56 patients were allocated to groups of 9 or 10 individuals who participated in group consultations, and 56 patients (considered control subjects) underwent individual visits plus support education. All visits were scheduled every 3 months.
RESULTS—After 2 years, HbA1c levels were lower in patients seen in groups than in control subjects (P < 0.002). Levels of HDL cholesterol had increased in patients seen in groups but had not increased in control subjects (P = 0.045). BMI (P = 0.06) and fasting triglyceride level (P = 0.053) were lower. Patients participating in group visits had improved knowledge of diabetes (P < 0.001) and quality of life (P < 0.001) and experienced more appropriate health behaviors (P < 0.001). Physicians spent less time seeing 9–10 patients as a group rather than individually, but patients had longer interaction with health care providers.
CONCLUSIONS—Group consultations may improve metabolic control in the medium term by inducing more appropriate health behaviors. They are feasible in everyday clinical practice without increasing working hours.
- CdR, Condotte di Riferimento
- DQOL, Diabetes Quality of Life
- GISED, Education Study Group of the Italian Society for Diabetes
Address correspondence and reprint requests to Massimo Porta, MD, PhD, Department of Internal Medicine, University of Turin, Corso AM Dogliotti 14, I-10126 Torino, Italy. E-mail:.
Received for publication 19 June 2000 and accepted in revised form 9 February 2001.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.