The diabetes pandemic: is structured education the solution or an unnecessary expense?



Structured education is a recommended clinical and cost-effective approach that adds value to traditional medical care. A clinical trial demonstrated that the X-PERT Diabetes Programme significantly improves health and quality of life. In order to determine if the national implementation of the X-PERT Programme meets standards identified in the published trial, it is necessary to conduct continuous audit.

To meet the key criteria to implement National Institute for Health and Clinical Excellence guidance, educators are trained to deliver X-PERT Diabetes and X-PERT Insulin Programmes and submit baseline, six-month and annual results onto the X-PERT Audit Database.

Forty-seven percent of X-PERT centres (55/118) have submitted data for 16 031 people with diabetes. Audit standards have been met with excellent attendance, evaluation and empowerment scores. All outcomes improved at one year: glycated haemoglobin (-0.6%); body weight (-3.0kg); waist circumference (-2.1cm); systolic (-0.9mmHg) and diastolic (-2.2mmHg) blood pressure; total (-0.2mmol/L) and LDL (-0.1mmol/L) cholesterol; triglycerides (-0.2mmol/L); HDL cholesterol (+0.1mmol/L); requirement for prescribed diabetes medication (23% less likely to increase medication, number needed to treat [NNT] = 4; 5% more likely to reduce medication, NNT = 19).

National implementation of the X-PERT Programme has met audit standards. X-PERT increases skills, knowledge and confidence for diabetes self-management, resulting in intensification of glycaemic control and reducing cardiovascular disease risk factors in people with newly diagnosed and existing diabetes. Structured education is a clinical and cost-effective approach that should be offered to all people with diabetes as an integral part of their diabetes treatment and management, potentially saving the NHS £367 million per annum. Copyright © 2011 John Wiley & Sons.

This paper was presented as the 2011 Janet Kinson lecture at the 2011 Diabetes UK Annual Professional Conference held in London