Educating patients in self-care plays a key role in diabetes treatment and is routinely included in the care of people with diabetes. Patient education can be provided individually or in groups and addresses patients’ rights and ability to influence and participate in their own care and treatment. This report summarizes the scientific evidence for individual- and group-based patient education programmes and psychological interventions involving supportive programmes based on congnitive behavioural therapy (CBT) and motivational interviewing methods (Motivational interviewing (MI); adaptations of motivational interviewing (AMI); motivational enhancement therapy (MET)). In this report, when we refer to motivational interviewing or MI methodology, we include one or more of the following three types: MI, AMI and/or MET. These methods are compared with usual care, i.e., the prevailing practice at the care unit in question.

Within the framework of the Swedish National Board of Health and Welfare’s work on national guidelines for diabetes care, SBU was commissioned to provide systematic literature reviews in several important areas. This literature review addresses patient education for people with diabetes. Other SBU reports address intensive glucose-lowering therapy in diabetes, systematic self-monitoring of blood glucose in noninsulin-treated diabetes, and dietary treatment of diabetes.

Conclusions

• The most important measure for long-term control of mean blood glucose is HbA_1C, which is also strongly linked to the prevalence of long-term complications. Group education programs for people with type 2 diabetes, led by people with expertise in the subject matter who are well versed in the educational methods of the programme, can substantially reduce HbA_1C after 1 to 2 years. Individual education for people with type 2 diabetes yields a small reduction in HbA_1C after 1 year. In estimating socioeconomic costs, SBU found that group education costs more than individual education due to more educational sessions over longer periods and the resulting differences in time and travel costs for participants. However, the costs are low in relation to the effect that group education has on HbA_1C.
• The scientific literature reveals no differences in effects on HbA_1C between usual care and motivational interviewing methods (MI, AMI, and MET) in monitoring people with diabetes up to 1 year.
• It is essential to study the effects on HbA_1C and quality of life from both individual- and group-based education in patients with type 1 diabetes.
• Controlled trials are needed to study the effects on HbA_1C and quality of life resulting from behavioural-oriented patient education through support programmes based on cognitive behavioural therapy (CBT) and motivational interviewing methods.