Lower education and immigrant background are associated with lower participation in a diabetes education program – Insights from adult patients in the Outcomes & Multi-morbidity In Type 2 diabetes cohort (OMIT)

Ragnhild B. Strandberg, Roy M. Nilsen, Frans Pouwer, Jannicke Igland, Rachel B. Forster, Anne Karen Jenum, Esben S. Buhl, Marjolein M. Iversen

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Objectives: Diabetes educational programmes should be offered to patients with type 2 diabetes mellitus (T2DM). We assessed the proportion of diabetes educational program participation among adults with T2DM, and its associations with place of residence in Norway, education, and immigrant background. Methods: We identified 28,128 diagnosed with T2DM (2008–2019) in the Outcomes & Multi-morbidity In Type 2 diabetes cohort. To examine associations between sociodemographic factors and participation in diabetes start courses (yes/no), we computed adjusted risk ratios (95% CI) using log-binomial regression. Results: Overall, 18% participated on the diabetes start course, but partaking differed by Norwegian counties (range:12–34%). Individuals with an immigrant background were 29% less likely to participate (RR 0.71, CI 0.65–0.79). Similarly, those with a lower educational level were 23% less likely to participate (RR 0.77, CI 0.72–0.83) than those with the highest education. The association between education and start course participation was not significant in the subgroup of immigrant individuals (RR 0.88 CI 0.70–1.12). Conclusions: We found that diabetes start course participation was overall low, especially in individuals with low education and immigrant background. Practice implications: More efforts are needed to promote diabetes start courses in patients with T2DM.
Original languageEnglish
Article number107577
JournalPatient Education and Counseling
Publication statusPublished - 1 Feb 2023


  • Diabetes self-management education and support
  • Education
  • Migrant background
  • Type 2 diabetes mellitus

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