Keynotes Diabetes UK March 2007
Newsletter of the DESMOND Collaborative & Network
T his year, 2007, is special to all who have been involvedbeginnings.
stages of the DESMOND Programme since its earliest
in the various
At this year’s Diabetes UK Annual Professional Confer-
ence, the study investigators, on behalf of the DESMOND
Collaborative, will present the final results from the
DESMOND randomised controlled trial. Aside from its
positive outcomes, the study is a great example of part-
nership and teamwork: between primary care, re-
searchers, practice staff and patient participants.
DESMOND owes a debt of thanks to many people and or-
ganisations. We hope the results justify the hard work and
dedication of our partners.
Meanwhile, it’s good to remember that the DESMOND is nothing less than a
radical new vision of intergrated care for people with Type 2 diabetes, deliv-
erable in the community. This means that while the RCT may have drawn to
a close, 2007 also marks a year of beginnings!
We would like to encourage health care professionals in primary care to think
about participating in one of the new research projects underway this year.
For anyone currently providing the Newly Diagnosed module, we have news
on the Foundation programme for people with established diabetes, and an
update on the imminent BME (Black and Minority Ethnic) module.
And as it is only possible to give a taster of what is happening in the world of
DESMOND in these pages, please do feel free to contact the Central Office
team for further information.
Dr Sue Roberts
National Clinical Director for Diabetes
D ESMONDreview into structured education in diabetes, which of
originated in 2003 as a direct result of the findings
that time found a lack of Type 2 diabetes education in England ful-
filling the criteria for quality, evidence-based programmes.
In response, a collaborative group from the UK pooled their expertise
and experience to envision a new way of delivering diabetes care in
line with the National Service Framework for Diabetes and NICE rec-
ommendations. The work of the DESMOND Collaborative as it be-
came, is directed by a Steering Group of 45+ individuals representing
13+ diabetes services, drawn from the spectrum of professions with
an interest in the condition, and includes people with diabetes and
representatives from Diabetes UK.
Structured education is central to this vision, not simply because it is
identified in all recent policy documents as an essential component of
modern diabetes care, but because it is widely recognised in chronic
disease programmes worldwide as critical to engaging individuals in
the self-management of their condition. Without education there can
be no long-term reduction in the complications of diabetes and the
consequent costs in human, clinical, societal and economic terms.
The DESMOND Randomised Controlled Trial (RCT)
T he DESMONDarandomisedgroup education programmetrialpa-
ing globally of structured
controlled trial is the largest
tients newly diagnosed with Type 2 diabetes. After three years of hard
work and commitment by all concerned, the study completed data
collection in January 2007.
The trial itself took place in 13 sites in England and Scotland, with a
total of 17 Primary Care Trusts (PCT) and 207 practices participating.
Of the1109 patients referred, 824 consented to take part. The level of
return of follow up data was extremely good, with over 90% of patients
providing data at 12 months follow-up. We are also fortunate that Dia-
betes UK has funded further follow-up of the participants to be con-
ducted at 3 years.
Following the presentation of the study results at this year’s DUK con-
ference, we will be looking forward to seeing the first papers of the
study appearing in the scientific press. Meanwhile, a selection of cur-
rent and recent references from the DESMOND project can be found
on the following page.
T he followingstudy and the Newly Diagnosed structured education
references are a guide to further information about the
module. For the full current bibliography, contact Claire Sutcliffe
DALLOSSO HM, CAREY ME, DAVIES MJ, HELLER S, KHUNTI K, SKINNER
TC (2006). Evaluating complex interventions in primary care: a progress re-
port on the DESMOND trial. Diabetic Medicine, 23(Suppl. 2):121.
DAVIES MJ, CAREY ME, DALLOSSO HM, HELLER S, KHUNTI K, SKINNER
TC (2006). Biomedical results at baseline and 12-month follow up from the
DESMOND (Diabetes Education and Self Management for Ongoing and
Newly Diagnosed) pilot study: P356. Diabetic Medicine. 23(Suppl. 2):119.
DAVIES MJ, CAREY ME, DALLOSSO HM, HELLER S, KHUNTI K, SKINNER,
TC on behalf of the DESMOND Collaborative (2006). ‘Effects of a structured
education programme on illness beliefs, QoL and physical activity in individ-
uals newly diagnosed with Type 2 diabetes: the DESMOND pilot study’,
poster presented at the 42nd Annual Meeting of the European Association
for the Study of Diabetes; 14-17 September 2006; Copenhagen.
SKINNER TC, DAVIES MJ, CAREY ME, DALLOSSO HM, HELLER S, KHUNTI
K (2006). DESMOND pilot study (Diabetes Education and Self Management
for Ongoing and Newly Diagnosed): belief and behaviour changes main-
tained through 12-months follow-up: P359. Diabetic Medicine, 23(Suppl.
Peer reviewed and professional journals
CAREY M and DALY H, 2004. Developing and piloting a structured, stepped
approach to patient education. Professional Nurse, 20:37-9.
SKINNER TC, CAREY ME, CRADOCK S, DALY H, DAVIES MJ, DOHERTY Y,
HELLER S, KHUNTI K, OLIVER L (2006). Diabetes education and self-man-
agement for ongoing and newly diagnosed (DESMOND): process modelling
of pilot study. Patient Education and Counselling, 64; 369-377
STONE, MA, PATEL N, DRAKE L, GAYLE C, 2006. Making education in dia-
betes culturally appropriate for patients. Practice Nursing,17(12);621-625.
2 006 has been a growth year for the DESMOND Newly Diagnosed
At present, over 60 of the newly configured Primary Care Trusts have be-
tween them over 325 Educators offering DESMOND as their local pro-
gramme for people newly diagnosed with Type 2 diabetes. This makes
DESMOND accessible to over one third of the UK population.
Our 3 regional teams have been travelling the length and breadth of the
country training new Educators. To date they have delivered 25 Train the Ed-
ucator courses. With an ever-growing ‘waiting list’ to take up the Newly Diag-
nosed module, the pending release of both the Foundation DESMOND and
DESMOND Black and minority ethnic (BME) modules, the future for
DESMOND looks extremely bright. We owe a debt of gratitude to members
of our regional training teams and their organisations for this success.
In addition to maintaining the high standard of our training, this year has seen
the introduction of the quality development (QD) framework. Through this we
provide ongoing mentoring and assessment for
Educators, leading to accreditation within the
DESMOND Programme. Educators are men-
tored through the process by one of our
trained QD Assessors.
The QD process has been developed to
ensure the consistency of content and
delivery within the DESMOND philosophy,
wherever and by whom DESMOND courses PCT
for patients are delivered.
If you are a Trust representative, a health care
professional interested in DESMOND, or sim-
ply want more information about the DESMOND
programme, please do not hesitate to contact any of
the Central Office Team who will be happy to answer
Michael Bonar & Alison Harding look after the
operational/logistical side of the Programme,
with Michael, as Programme Manager, dealing
with finance and design, and Alison, as Oper-
ations Coordinator, being responsible for
training and quality development. 18
Be a pioneer in primary care!
Y ou may have can still the opportunity to participate in the DESMOND
RCT, but you
take up the challenge to be a pioneer by taking
part in one of the two studies below. If your organisation is delivering the
DESMOND Newly Diagnosed programme as part of routine care, there is
still time to register interest and apply for further information.
Blood glucose monitoring study
T he DESMOND Collaborative has received three year funding from Dia-
betes UK to run the Self Monitoring of Blood Glucose Trial. The study
will investigate whether self-monitoring of blood glucose as opposed to uri-
nalysis provides additional benefit to newly diagnosed patients with Type 2
diabetes receiving structured group education.
Like the DESMOND randomised controlled trial, this study will take place in
primary care. Practices will be randomised to refer patients to a DESMOND
course that covers either blood glucose monitoring or urinalysis. Recruit-
ment of PCTs has already begun, but it is not too late to take part. For further
information without obligation contact Helen Dallosso (helen.dallosso@uhl-
Lay Educators Lay Patient Educator Study
C delivereducators working in partnership with health care professionals
the DESMOND Newly Diagnosed Module with the same integrity
and to the same standard as a health care professional team? That’s the
question to be answered by this study funded by Diabetes UK, and taking
place in primary care. If the answer is positive, and if the economic implica-
tions are favourable, then this study has the potential to signpost a cost ef-
fective way for primary care organisations to increase their capacity to
deliver structured education.
We are looking for 6 PCTs to participate. Recruitment and training of lay ed-
ucators would be organised by the study research team. Monies are avail-
able for items such as training, course resources and payments to HCP and
lay educators for their time.
For further information and to register interest without obligation, contact
Panna Mandalia (firstname.lastname@example.org).
D ESMOND for the South Asian
The long wait is almost over! In Au-
tumn 2007 training for Interpreters
and Educators to deliver the
DESMOND module for the South
Asian community will at last be avail-
able. This will be supported by cultur-
ally appropriate resource packs and
patient materials developed by health
care professionals in conjunction with
patients and their communities.
Building on the work of our Diabetes
UK-funded action research project,
work has been continuing over the
last 6 months to shape up existing
materials, create exciting new re-
sources, and develop a one-day train-
ing programme for Interpreters and
the Educators working with them to
deliver this breakthrough DESMOND
Further information and costs will be
available from June 2007. But to reg-
ister interest without obligation, con-
tact Alison Harding
Other Projects Research in development
T for DESMOND Foundation Module, an initialmirrors the Newly Di-
people with established diabetes which
6 hours of education
agnosed Module, will shortly be available in the form of a conversion
pack to accompany the current manual issued at Educator training.
It will be provided free of charge to all existing Educators actively deliv-
ering DESMOND in PCTs with a current subscription to the pro-
gramme. Subsequently, it will be provided as an integral part of the
Educator Manual to new trainees.
T the Foundation Module DESMOND integrated pathway. Model,
main section of the
will pave the way for the Ongoing
At the present time, funding is being sought to support piloting of the
training, patient education and clinical management sections of the
model as developed by the task groups of the DESMOND
M eanwhile, we are pleased tomodule hasthat a DESMOND pre-dia-
betes prevention education
recently received funding
as part of a larger Diabetes Prevention Programme grant. pre-diabetes
This education module will target those at risk of developing diabetes
and focus on diet and lifestyle issues, in particular on increasing levels
of physical activity. The five year research study will be steered by an
international group of investigators.
Do you have a question about
DESMOND? Interested in taking
on the programme? Want to know
more about taking part in research?
Whatever your information need,
there is someone in our team who
can provide answers.
DESMOND Project Team
Dr Marian Carey DESMOND Central Office
National Director Ward 38, Level 6, Windsor Building,
t: 0116 258 7757 Leicester Royal Infirmary,
e: email@example.com Infirmary Square,
Leicester, LE1 5WW
PA to National Director t: 0116 258 7757
t: 0116 258 7757 f: 0116 258 6165
e: firstname.lastname@example.org w: www.desmond-project.org.uk
Dr Helen Dallosso
Senior Research Associate
t: 0116 258 5881
t: 0116 258 5881
t: 0116 258 5881
t: 0116 258 5881