Do Group Classes Work to Improve Diabetes Control?

As the sheer numbers of people who develop diabetes continues to climb, we as health care providers need to look at creative ways to provide the in depth information and teaching that is required to help patients take the best possible care of their diabetes.   One of these approaches is to teach about diabetes in the form of group classes.  The question is, has the group teaching approach been proven to improve diabetes control?

Many studies have actually been done on this subject, ranging from observational studies to randomized controlled trials.  A meta-analysis in the Canadian Medical Association Journal by Housden et al, which looks at all of the literature on this topic to date, found that the class teaching approach improves hemoglobin A1C (a marker of overall diabetes control) by -0.46%.  While this is only a modest improvement in diabetes control, it is not much different than the A1C improvement we may expect to see in a patient who is close to A1C targets but not quite there, following addition of another oral medication.  

Anecdotally, I have often had my patients report back to me that they have really enjoyed being part of a diabetes education class, as it not only provides excellent information, but it also provides the opportunity for diabetics to support each other, and talk to each other about their experiences.  Knowing that you are far from alone in your diagnosis of diabetes can often go a long way to feeling secure and empowered in your journey towards improving upon your health!

If you are a diabetic and interested in group education classes, ask your doctor what is available.  Most centres of diabetes care (including our own) offer group classes free of charge.  Give it a try!


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www.drsue.ca © 2013

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Ending The Diet Debate

If you're a person looking for dietary advice to embark on a successful weight management journey, it can be an overwhelming and confusing task to try to navigate all the information that is out there.   I am often asked by my patients about the Zone, Atkins, Paleo, South Beach Diet, and many others.  The question is, is there a certain type of food, or proportion of protein, carbohydrate, and fat that makes up the magical formula to successful weight loss?

The answer to this question, as summarized in a recent article by Dr Sherry Pagoto in JAMA, is that research does not support that any one diet composition is better than another to result in successful weight loss.  As Dr. Pagoto notes,

"The ongoing diet debate exposes the public to mixed messages emanating from various trials that have yielded little but have heavily reinforced a fad diet industry."

What does matter is adherence - in other words, when you start a food plan, can you stick to it in the long term?   I don't use the word 'diet' when I'm counselling my patients - I use the words 'permanent lifestyle change'.    Don't bother making a change unless it is a change that you can stick to for the rest of your life - doing a certain program for the short term may help you to lose weight, but when you stop the program, what will happen?  The reality is that about 95% of people will regain the weight, and then some.

Remember that it's not about dropping weight fast - a plan that results in rapid weight loss is probably quite drastic, and is unlikely to be a permanent lifestyle change.  Successful weight management is about gradually losing weight (1-2lb per week) with permanent lifestyle change, and keeping it off by making those changes permanent.

Remember that for someone with obesity, losing 5% of your body weight and keeping it off decreases the risk of developing complications of obesity and prolongs lifespan - the greatest success of all!

@drsuepedersen

www.drsue.ca © 2013

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