It is disappointing, though perhaps not surprising, that the intervention and control groups in the DESMOND study showed no difference in glycated haemoglobin or in any quality of life measure at one year.1 The difference of 1.1 kg in weight—though significant—is not, frankly, terribly impressive.
Many of us were alarmed when the Department of Health began to exert pressure on diabetes services to adopt and implement DESMOND before a proper evaluation. We now see that this approach is unlikely to be cost effective in the management of most patients with type 2 diabetes, and the case for its universal introduction has effectively collapsed.
The lesson here is that—just like drugs or surgical procedures—educational interventions need rigorous piloting and assessment, as was performed by the DESMOND group, before politicians jump on the bandwagon and insist that they are the answer to everybody’s prayers.
Competing interests: None declared.
References
- 1.Davies MJ, Heller S, Skinner TC, Campbell MJ, Carey ME, Cradock S, et al; on behalf of the Diabetes Education and Self Management for Ongoing and Newly Diagnosed Collaborative. Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial. BMJ 2008;336:491-5. (1 March.) [DOI] [PMC free article] [PubMed] [Google Scholar]