Short-term efficacy of high intensity group and individual education in patients with type 2 diabetes: a randomized single-center trial

  • R. Reale
  • A. Tumminia
  • L. Romeo
  • N. La Spina
  • R. Baratta
  • G. Padova
  • L. Tomaselli
  • L. FrittittaEmail author
Original Article



The aim of this randomized study was to examine the efficacy of two high intensity educational programs: the conversation maps-based (CM™) education and the individual education (IE), compared to usual care (UC) in a cohort of type 2 diabetic (T2DM) patients.


Ninety T2DM outpatients (30 per group) were randomized and 79 finished the study and were analyzed. The CM™ and IE groups received four educational sessions at 0, 4, 8 and 12 weeks, while the UC group received two brief individual sessions at 0 and 12 weeks. We evaluated glycemic control (HbA1c), diabetes treatment, body mass index (BMI) and carried out a questionnaire survey at three time points (before intervention, at 12 and at 32 weeks) to assess patients’ satisfaction, attitudes toward diabetes and dietary knowledge.


All the three groups showed a significant and comparable reduction of both HbA1c and BMI. Diabetes therapy needed to be reinforced in a higher percentage of cases (39.3%) among UC patients compared to the IE (14.8%; p = 0.04) and the CM™ (8.3%; p = 0.01) groups. At 32 weeks Diabetes Treatment Satisfaction (DTSQ Q1 + Q4–8) significantly improved in the CM™ group (25.8 ± 4.5 vs. 22.4 ± 6.0; p < 0.01) and attitudes toward diabetes (ATT19) significantly improved in the IE group (58.0 ± 4.7 vs. 55.3 ± 5.1; p = 0.02).


Our trial provides preliminary data regarding the efficacy of structured group and individual education on achieving better glyco-metabolic control without drug therapy reinforcement and with positive effects on patients’ attitude and treatment satisfaction.


Type 2 diabetes Conversation map Individual education Treatment satisfaction 



Conversation Map


Individual education


Usual care


Body mass index


Glycated hemoglobin


Diabetes Treatment Satisfaction Questionnaire


Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology


Diabetes Integration Scale-19


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Italian Society of Endocrinology (SIE) 2018

Authors and Affiliations

  • R. Reale
    • 1
  • A. Tumminia
    • 1
  • L. Romeo
    • 1
  • N. La Spina
    • 1
  • R. Baratta
    • 2
  • G. Padova
    • 2
  • L. Tomaselli
    • 2
  • L. Frittitta
    • 1
    • 3
    Email author
  1. 1.Endocrinology, Department of Clinical and Experimental MedicineUniversity of Catania, Garibaldi HospitalCataniaItaly
  2. 2.Endocrinology UnitGaribaldi HospitalCataniaItaly
  3. 3.Diabetes, Obesity and Dietetic CenterGaribaldi HospitalCataniaItaly

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