A Cochrane review included 9 studies with a total of 1 359 subjects. 6 studies compared individual face-to-face education to usual care and 3 compared individual education to group education. Individual face-to-face patient education for type 2 diabetes did not significantly improve glycaemic control over a 12 to 18 month period (WMD in HbA1c -0.1%, 95% CI -0.3 to 0.1; 4 studies, n=632). However, there did appear to be a significant benefit of individual education on glycaemic control in a subgroup analysis of 3 studies involving participants with a higher mean baseline HbA1c greater than 8% (WMD -0.3%, 95% CI -0.5 to -0.1). There was no significant difference in glycaemic control between individual or group education at 12 to 18 months (WMD in HbA1c 0.03%, 95% CI -0.02 to 0.1; 2 studies). There was no significant difference in the impact of individual versus usual care or group education on body mass index, systolic, or diastolic blood pressure. There were too few studies to perform a meta-analysis on the effect of individual education on dietary self management, diabetes knowledge, psychosocial outcomes and smoking habits.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and inadequate intention-to-treat adherence) and by indirectness (in some studies individual education and usual care were quite similar).