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Diabetes Educ. 2009 Jan-Feb;35(1):72-96. doi: 10.1177/0145721708326774.

Costs and benefits associated with diabetes education: a review of the literature.

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Health Services Research and Development, Harry S. Truman Memorial Veterans’ Hospital, Columbia, Missouri (Dr Boren)
Department of Health Management and Informatics, University of Missouri, Columbia, Missouri ( Dr. Boren, Ms Panhalkar)
American Association of Diabetes Educators, Chicago, Illinois (Dr Fitzner, Mr Specker)



The purpose of this article was to review the published literature and evaluate the economic benefits and costs associated with diabetes education.


The Medline database (1991--2006) and Google were searched. Articles that addressed the economic and/or financial outcomes of a diabetes-related self-care or educational intervention were included. The study aim, population, design, intervention, financial and economic outcomes, results, and conclusions were extracted from eligible articles.


Twenty-six papers were identified that addressed diabetes self-management training and education. Study designs included meta-analysis (1); randomized controlled trials (8); prospective, quasi-experimental, and pre-post studies (8); and retrospective database analyses (9). The studies conducted cost analyses (6), cost-effectiveness analyses (13), cost-utilization analyses (7), and number needed to treat analyses (2). More than half (18) of the 26 papers identified by the literature review reported findings that associated diabetes education (and disease management) with decreased cost, cost saving, cost-effectiveness, or positive return on investment. Four studies reported neutral results, 1 study found that costs increased, and 3 studies did not fit into these categories.


The findings indicate that the benefits associated with education on self-management and lifestyle modification for people with diabetes are positive and outweigh the costs associated with the intervention. More research is needed to validate that diabetes education provided by diabetes educators is cost-effective.

[Indexed for MEDLINE]

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