Key points are not available for this paper at this time.
ABSTRACT Aims To examine the dose–response relationship between diabetes self‐management education (DSME) attendance and psychological outcomes in type 2 diabetes, assessing whether minimal attendance (10%) produces clinically meaningful improvements and comparing outcomes at the internationally adopted 60% completion benchmark with full (100%) completion. Materials and Methods This randomised feasibility trial enrolled 120 adults (≥ 18 years) due to attend a UK DSME programme. Participants were randomised to receive 100% (routine DSME), 60%, 10% or 0% (delayed DSME). Primary outcomes were changes in self‐management skills; secondary outcomes included health‐related quality of life (HRQoL) and diabetes distress. Results Participants had a mean age of 61 years, mean HbA 1c of 8.4% (68 mmol/mol) and median diabetes duration of 8 years. Significant between‐group differences were observed in change scores for self‐management skills ( F 3,109 = 6.914, p < 0.001) and diabetes distress ( F 3,108 = 7.369, p < 0.001). Education dose explained 16%–17% of the variance demonstrating a dose–response relationship (η p 2 = 0.16–0.17) with a moderate effect size ( n 2 = 0.16, 95% CI 0.04, 0.27). Within‐group statistical improvements were observed for both 100% and 60% completion, but clinically meaningful improvements across all psychological domains occurred only with full (100%) completion. No significant between‐group differences were observed for HRQoL. Conclusions In this randomised feasibility trial, clinically significant psychological benefits from DSME required full (100%) programme completion. Attendance thresholds of ≤ 10% or partial completion (≥ 60%) did not yield meaningful improvements in diabetes distress or HRQoL. These findings suggest that existing performance indicators based on partial attendance may not reflect meaningful benefits and support 100% DSME attendance as the gold standard. Trial Registration Clinicaltrials.gov identifier: NCT06419907
Lewis et al. (Wed,) studied this question.