Evaluation of progression to diabetes in high-risk patients eligible to attend the ‘Walking Away from Diabetes’ educational intervention: a retrospective cohort study

2020 
Aims:  To retrospectively assess the efficacy of a pragmatic education programme called ‘Walking Away from Diabetes’ (WAD), a single-session intervention aimed at patients who are at risk of developing type 2 diabetes mellitus (T2DM). Methods:  Baseline and follow-up data for 6,116 patients, identified as ‘at risk of diabetes’ in the period April 2012 to March 2016, were assessed for T2DM status in January 2018. Any differences in outcome between WAD attenders and non-attenders was explored using Kaplan–Meier, log rank testing and Cox regression analyses. Results:  During the follow-up period, 426 of 3,470 (12.3%) WAD attenders and 349 of 2,646 (13.2%) non-attenders were diagnosed with T2DM (p=0.068, log rank test). Cox regression showed that HbA 1c  (hazard ratio (HR) 1.23, p<0.001) and high density lipid levels (HR 0.67, p<0.001) rather than WAD attendance (HR 0.89, p=0.11) were the two main factors associated with progress from ‘at risk’ to T2DM. Conclusions:  Although the wider health impact of the WAD programme was not considered here, session attendance does not appear to reduce the risk of developing T2DM. However, other factors influence the risk of developing T2DM. It is essential for educational programmes, designed to have a preventative effect for people at risk of diabetes, to be assessed for short- and long-term efficacy.
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