The effect of an education programme (MEDIAS 2 ICT) involving intensive insulin treatment for people with type 2 diabetes

ObjectiveIn a randomized, multi-centre trial, the effect of an education programme (MEDIAS 2 ICT) involving intensive insulin treatment for people with type 2 diabetes was compared with an established education programme as an active comparator condition (ACC).MethodsWe investigated whether MEDIAS 2 ICT was non-inferior to ACC in overall glycaemic control. Secondary outcomes were the diabetes-related distress, diabetes knowledge, quality of life, self-care behavior, lipids, blood pressure and weight.Results186 subjects were randomized. After a six month follow-up the mean HbA1c decrease was 0.37% (from 8.2 ± 1.1% to 7.8 ± 1.5%) in the ACC and 0.63% (from 8.5 ± 1.5% to 7.9 ± 1.2%) in MEDIAS 2 ICT. The mean difference between both groups was −0.26% (95% CI −0.63 to −0.14) in favor of MEDIAS 2 ICT. This result was within the predefined limit for non-inferiority. Diabetes-related distress was significantly more reduced in MEDIAS 2 ICT (−3.4 ± 7.1) than in ACC (0.4 ± 9.0; p = 0.31).ConclusionMEDIAS 2 ICT is as effective in lowering HbA1c as previously established education programmes, but showed superiority in reducing diabetes-related distress.Practical implicationsMEDIAS 2 ICT provides an alternative for education of people with type 2 diabetes treated by multiple injection therapy.

► MEDIAS 2 ICT was associated with a clinical relevant reduction of HbA1c. ► Randomized trial proved non-inferiority of HbA1c reduction compared to control group. ► Reduction of diabetes related distress was significantly higher in MEDIAS 2 ICT. ► Self care, quality of life and diabetes knowledge were also improved in MEDIAS 2 ICT.