Declining structured diabetes education in those with type 2 diabetes: A plethora of individual and organisational reasons

Objectiveto identify the expressed reasons adults with type 2 diabetes decline structured diabetes education (SDE).Methodscross sectional survey of 335 adults with type 2 diabetes who had declined SDE within the past two years, from across Northern Ireland and England.Standardised instruments comprising The Diabetes Attitude Scale, Diabetes Empowerment Scale (Short Form), and Diabetes Knowledge Test plus a questionnaire to elicit the reasons for declining SDE were used.ResultsMean age 57.6 years (±21.1) 50.7% males, predominantly of White ethnicity (85.7%). They were most frequently invited to attend by a diabetes specialist nurse (36%), general practitioner (27%) or practice nurse (19%).Although a diversity of reasons for declining SDE were cited the most common were; ‘The course was too long’ (47.2%), ‘I have other health problems’ (41.2%) and they had other priorities (33.4%).Hierarchical cluster analysis revealed that expressed reasons for declining SDE were highly individualised.ConclusionThe wide range of reasons that impeded attendance suggests there is no simple solution that will improve attendance rates.Practice implicationsIn the same way that medical treatment for diabetes is becoming increasingly individualised, educational provision should be encouraged to move away from a one size fits all model.