Evaluation of an audiovisual diabetes education program - Negative results of a randomized trial of patients with non-insulin-dependent diabetes mellitus

A randomized controlled trial was conducted to determine whether an education program specifically designed for patients with non-insulin-dependent diabetes and limited literacy could improve and sustain glucose and weight control. From a referral clinic, 120 obese (>130 per cent of ideal body weight) diabetic patients who were not taking insulin were recruited. Of these, 55 per cent were female and 49 per cent were black; the mean age was 53 years. Mean glycosylated hemoglobin (HbA₁%) was 10.2 per cent. Each subject was assigned to one of three groups: 1) monthly group sessions with videotapes for diabetic persons with low literacy skills; 2) monthly group sessions without videotapes; or 3) no monthly sessions. After seven months, there had been 16 dropouts (13 per cent). Differences in weight changes between groups were significant (p<0.05); group 1 lost a median of 1 kg of weight (p<0.05) compared with a 0.1-kg loss and no change in groups 2 and 3, respectively. This weight loss was not sustained at 11 months. There was no significant change in HbA₁%. Age, education, and compliance beliefs did not predict outcome. The authors conclude that the patient education programs did not result in sustained glucose or weight control.