What question did this study set out to answer?

This analysis aims to understand the impact of diabetes self-management education on cause-specific mortality rates in adults with type 2 diabetes.

June 7, 2026

1512-P: Diabetes Self-Management Education (DSME) and Cause-Specific Mortality Rates in Adults with Type 2 Diabetes in England: An Epidemiological Analysis

Key Points

This analysis aims to understand the impact of diabetes self-management education on cause-specific mortality rates in adults with type 2 diabetes.
Retrospective epidemiological analysis of 364,703 adults with type 2 diabetes using primary care and mortality data.
Patients were matched for age, sex, age at diagnosis, and diabetes duration.
Poisson and negative binomial regression were used to estimate mortality rates.
Lower all-cause mortality in DSME attendees (26.99 vs. 44.85 deaths per 1,000 person-years, RR 0.60).
Significant reductions in specific mortality rates: renal disease (0.42), diabetes (0.47), sepsis (0.45), dementia (0.49), liver disease (0.49), respiratory disease (0.51), and stroke (0.51).
In total, there were 11,230 deaths among DSME attendees and 73,010 among non-attendees.

Abstract

Introduction and Objective: Mortality is increased in type 2 diabetes, but a 2025 scoping review reported a 45% mortality risk reduction (pooled RR 0.55, 95% CI 0.47-0.63, p 0.0001) after DSME(1). We examined DSME impact on cause specific mortality rates in type 2 diabetes in England. Methods: In a retrospective epidemiological analysis, primary care records of 364,703 adults with type 2 diabetes were linked to UK Office for National Statistics mortality data(2) in patients matched at baseline for age, sex, age at diagnosis and diabetes duration. We used Poisson and negative binomial regression to estimate all-cause and cause-specific mortality rates in those that had ever (n=75,343) or never (n=289,360) had DSME, adjusting for covariates. Results: In patients, mean age 70 years, diabetes duration 6 years and HbA1c 7.9%, there were 11,230 deaths in those who had ever and 73,010 in those who had never attended DSME. All-cause mortality was lower in DSME attendees (26.99 vs. 44.85 deaths per 1,000 person-years, rate ratio RR 0.60), incidence rate ratio 37% (0.63, 0.61-0.64, p0.001), including renal disease (0.42), diabetes (0.47), sepsis (0.45), dementia (0.49), liver disease (0.49), respiratory disease (0.51), and stroke (0.51). Conclusion: DSME attendance was associated with lower all-cause and cause-specific mortality in adults with type 2 diabetes, underscoring the importance of DSME, although causality cannot be inferred. Disclosure G.A. Lewis: None. D. Hughes: None. G. Irving: None. J. Wilding: Advisory Panel; Ended; Alnylam Pharmaceuticals, Inc. Advisory Panel; Current; Amgen Inc., AstraZeneca, Kailera, Eli Lilly and Company. Speaker's Bureau; Current; Medscape. Advisory Panel; Ended; Menarini Group. Advisory Panel; Current; Novo Nordisk A/S. Advisory Panel; Ended; Pfizer Inc., Saniona. Speaker's Bureau; Current; Boehringer Ingelheim International GmbH. Advisory Panel; Ended; Shionogi & Co., Ltd. K.J. Hardy: None.

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Cite This Study

Lewis et al. (Fri,) studied this question.

synapsesocial.com/papers/6a250be87def13d035e1bdd0 https://doi.org/https://doi.org/10.2337/db26-1512-p

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