A structured education program for improving cardiovascular risk and glycaemic control in type 2 diabetes mellitus (the SUGAR study).

Abstract

Aims: Structured community-based diabetes education programs may improve cardiometabolic outcomes, yet objective evidence remains limited. We evaluated the efficacy of a multidisciplinary education program in improving glycaemic control and cardiovascular risk factors in adults with type 2 diabetes mellitus (T2DM).

Methods: Adults with T2DM participated in a four-week program comprising weekly two-hour sessions on diabetes and cardiovascular disease, nutrition, exercise, and mental health. HbA1c, body mass index (BMI), weight, blood pressure, and lipid profile were assessed at baseline and at 3, 6, and 12 months. Outcomes were analysed using pooled linear mixed-effects models with multiple imputation, with sensitivity analyses excluding participants requiring pharmacotherapy escalation.

Results: Fifty participants (median age 49 years; 38 % female) completed the program. HbA1c improved significantly and was sustained at 12 months (-1.57 % (95 %CI(-1.96, -1.17), p < 0.001). LDL cholesterol (-0.51 mmol/L (95 %CI(-0.71,-0.30), p < 0.001), triglycerides (-0.86 mmol/L (95 %CI(-1.34,-0.39), p = 0.001), and BMI (-1.45 kg/m², 95 %CI(-1.99,-0.91), p < 0.001) also improved at 12 months. These findings were supported by sensitivity analysis for HbA1c, but attenuated for other cardiometabolic parameters at 12 months.

Conclusions: A structured, multidisciplinary community-based education program was associated with significant improvements in glycaemic control and key parameters of cardiometabolic risk. As a cost-efficient model, it offers a scalable strategy for T2DM management in primary care, warranting further evaluation of interactions with pharmacotherapy.