Diabetes self-management training program in a community clinic improves patient outcomes at modest cost

J Am Diet Assoc. 2004 May;104(5):807-10. doi: 10.1016/j.jada.2004.02.027.


Stringent glycemic control reduces complications and health care costs for people with diabetes. This study assessed the effectiveness of a diabetes self-management training (DSMT) program at a community clinic. Education and a glucometer were provided to 70 people with type 2 diabetes in a 4-hour class, followed by individual dietitian consults and monthly support meetings. Most participants were Hispanic or African American with mean age of 49+/-10 years and mean body mass index of 34+/-9. Body weight, glycosylated hemoglobin (A1C), medications, and follow-up attendance were monitored. After 2 to 12 months of program participation, mean A1C improved from 9.7+/-2.4% to 8.2+/-2.0% (P<.001); 61% experienced positive medication outcomes. The cost of community clinic DSMT was approximately $280 per person per year, $185 for each point reduction in A1C. This study indicated that community clinic DSMT can improve glycemic control at modest cost.

MeSH terms

  • African Continental Ancestry Group / education
  • Blood Glucose Self-Monitoring / methods*
  • Body Mass Index
  • Community Health Services / organization & administration*
  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Glycated Hemoglobin A / analysis
  • Hispanic Americans / education
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic*
  • Poverty
  • Program Evaluation
  • Self Care*


  • Glycated Hemoglobin A