Diabetes Forecast

The Benefits of Learning as a Group

When it comes to diabetes education, there’s power in numbers

By Deborah Burstyn , , ,
african american woman at conference table

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The People

As diabetes rates across the U.S. continue to climb, Alameda County, Calif., residents with type 2 diabetes are learning how to manage their condition and improve their health—together. Adults of various ages, ethnicities, and years of living with diabetes are taking an eight-week comprehensive diabetes self-management class provided by the Alameda County Public Health Department’s Diabetes Program.

The Issue

“We saw too many people with complications from diabetes and a lack of access to education,” says Brenda Rueda-Yamashita, Chronic Disease Program director for the public health department. “Doctors do their best, but they just can’t tell people all they need to know in the allotted 15-minute visit.”

The Education Plan

The program provides 16 hours of diabetes self-management education to small groups of eight to 12 participants in convenient locations, such as retirement homes and senior centers. Instructors share information about nutrition, cooking, exercise, stress reduction, and medication management. Participants receive an A1C test (a measure of average blood glucose for the past two or three months) at the first class and again three months later to assess changes in blood glucose management after completing the program. Instructors also monitor participants’ blood pressure and weight, other key measures in diabetes health.

The Results

During class sessions, discussions are lively. At one session, instructor Marisa Castaldini, RD, MS, CDE, asks a group of seven participants with type 2 diabetes: “So tell me, which foods are going to raise your blood sugar?” Ms. H., 63, calls out, “Cookies, pie, candy—all the stuff that we love.” “Corn and rice,” adds Ms. G., 63. “Milk and yogurt, too,” says Mr. C., 62. “They got milk sugar in them.” They go on to discuss the fact that foods labeled “sugar free” can still contain carbohydrates and how to find the carbohydrate grams per serving on a food label. “We have to become like Sherlock Holmes,” says Mr. C. “We need to play detective to figure this stuff out.” That knowledge is empowering participants to take control of their diabetes. In many cases, class members are succeeding in lowering their blood sugar levels and thus lowering their risk of health complications.


Diabetes self-management education provided in a group setting by an American Diabetes Association–recognized education program is typically covered by insurance plans when a person is newly diagnosed and for “tune-ups” in subsequent years. Visit diabetes.org/findaprogram to locate a program in your area.

The Alameda County Public Health Department Diabetes Program started 13 years ago and is the only American Diabetes Association–recognized public health department program in California.

Readers and Educators

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