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. Copyright © 2017 John Wiley & Sons.

A significant number of people with type 1 diabetes do not attend their clinic appointments. This study investigated the reasons underlying this decision and explored possible service improvement strategies.This was a cross‐sectional telephone survey among all patients with type 1 diabetes missing at least one appointment at a diabetes clinic between 1 October 2009 and 30 September 2010. Patients were asked two questions: why they did not attend the appointment and how attendance could be improved.The initial ‘did not attend’ (DNA) rate for all appointments was 17.6% (808/4595 appointments). Of these, the largest number were missed by patients (n=252) with type 1 diabetes. After excluding 79 patients no longer under the service, 126/173 (72.8%) were able to be contacted and answered the questions. Forgetting the appointment was the most frequent response (34.9%). Many patients advised not to send appointment reminder letters too far ahead of appointments (12.7%, 16) and to send a text message reminder (26.2%, 33) two weeks before the appointment.The findings suggest that there is a role for improving the administrative approach to patients' appointments, reminding patients in advance and improving communication between hospital staff and patients. Copyright © 2012 John Wiley & Sons.

Much of the literature on the causes and management of diabetes focuses on biomedical and lifestyle factors, with little attention given to the role of social issues in diabetes management. This study aimed to explore the influence of social issues on type 1 diabetes management from the perspectives of people with diabetes and of health care professionals (HCPs), and to identify strategies to enhance the clinic services.Semi-structured interviews and focus groups were conducted with eight people with type 1 diabetes and with 15 HCPs. Recruitment was through the patients' HCPs for this service evaluation project.Findings highlighted the importance of considering the influence of social issues on diabetes management. The dominant themes that emerged from the thematic analysis were: housing situations, divorce, stress, literacy issues, social stigma and financial issues. HCPs suggested ways to improve services by: putting informational boards (e.g. related to benefit services) in the waiting area; providing a peer support platform (to discuss and gain support related to social issues); having a service directory (to refer people to the social services); working at multi-settings (to understand the effect of social issues); and having open clinics at weekends (to support those who are unable to get time off during the week). People with diabetes suggested that bringing in a welfare officer and providing information about benefits could improve the clinic services.In conclusion, including a systematic assessment of social parameters in health care records might improve the ability of clinicians and the health system to tackle social issues early. This is likely to improve self-management and biophysical outcomes.