Group visits improve metabolic control in type 2 diabetes - A 2-year follow-up

OBJECTIVE - To evaluate whether group visits, delivered as routine diabetes care and structured according to a systemic education approach, are more e ffective than individual consultations in improving metabolic control in no n-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 w ho participated in group consultations, and 56 patients (considered control subjects) underwent individual visits plus support education. All visits w ere scheduled every 3 months. RESULTS - After 2 years, HbA(1c) levels were lower in patients seen in grou ps than in control subjects (P < 0.002). Levels of HDL cholesterol had incr eased 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 di abetes (P < 0.001) and quality of life (P < 0.001) and experienced more app ropriate health behaviors (P < 0.001). Physicians spent less time seeing 9- 10 patients as a group rather than individually, but patients had longer in teraction with health care providers. CONCLUSIONS - Group consultations may improve metabolic control in the medi um term by inducing more appropriate health behaviors. They are feasible in everyday clinical practice without increasing working hours.