Empowerment-based education for established type 2 diabetes in rural England

People with newly-diagnosed type 2 diabetes are offered structured education, but there are few programmes for those with established diabetes. The empowerment-based education approach from the United States has been advocated as one approach that supports self-management, but is not used in England. The aim of this study was to assess the acceptability of empowerment-based diabetes education for patients with established type 2 diabetes. One 3.5-hour workshop was offered to participants joining a trial of peer support in rural Cambridgeshire, UK. Four main aspects of self-care (carbohydrates and portion size; truths and myths about diabetes; know your numbers and medications; keeping active and foot care) were addressed, followed by a question and answer session. Change in diabetes knowledge and participant perspectives were evaluated using questionnaires. Qualitative evaluation was by ethnographic observation of sessions. Patient expectations were met in 93.5% of participants. Aspects thought to be particularly useful related to diet and carbohydrates and also medications. Ethnography revealed five main themes: diet, group process, health service experience, within session peer support, and educator clinical grounding. Sixty percent of those participating increased their ability to answer diabetes knowledge-based questions. Adopting the ‘empowerment approach’ is a valid method of diabetes education for those with established type 2 diabetes in England. Delivery by experienced educators is important to address queries that arise during the sessions