We wish to support Beverly et al. in confirming the efficacy of small-group education in older patients with diabetes (1). However, their suggestion that the majority of education programs are designed for younger/more recently diagnosed patients and that minimal attention has been paid to the development of successful interventions for older adults with diabetes is at conflict with much recent (2), and less recent (3), literature.

We have been running small-group education in individuals with type 2 and type 1 diabetes for many years and have reported favorable lifestyle changes, improved health behaviors, and lower HbA1c in both (4,5). We concur that, apparently, better results are observed when education is offered to older patients. Possibly, this is because interventions are centered on lifestyle issues whereas a more technical approach, including carbohydrate counting and self-monitoring, is necessary to improve clinical outcomes in individuals with type 1 diabetes (5). In either case, continuous reinforcement over the years is key to sustained change and improvement.

Health professionals are to realize that, similarly to glucose-lowering agents, education should be a lifelong treatment if it is to display its value as an instrument of change and self-care. One-off or even relatively short-term interventions do not provide lasting benefits and will lead to the flawed conclusion that education is ineffective.

No potential conflicts of interest relevant to this article were reported.

1.
Beverly
EA
,
Fitzgerald
S
,
Sitnikov
L
,
Ganda
OP
,
Caballero
AE
,
Weinger
K
.
Do older adults aged 60–75 years benefit from diabetes behavioral interventions?
Diabetes Care
2013
;
36
:
1501
1506
2.
Steinsbekk
A
,
Rygg
,
Lisulo
M
,
Rise
MB
,
Fretheim
A
.
Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis
.
BMC Health Serv Res
2012
;
12
:
213
3.
Norris
SL
,
Engelgau
MM
,
Narayan
KM
.
Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials
.
Diabetes Care
2001
;
24
:
561
587
4.
Trento
M
,
Gamba
S
,
Gentile
L
, et al
ROMEO Investigators
.
Rethink Organization to iMprove Education and Outcomes (ROMEO): a multicenter randomized trial of lifestyle intervention by group care to manage type 2 diabetes
.
Diabetes Care
2010
;
33
:
745
747
5.
Trento
M
,
Borgo
E
,
Kucich
C
, et al
.
Quality of life, coping ability, and metabolic control in patients with type 1 diabetes managed by group care and a carbohydrate counting program
.
Diabetes Care
2009
;
32
:
e134
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.